Dinner Ticket Order Form

Thank you for volunteering at Make Smoking History Targa West.

Registered Officials are able to purchase a heavily discounted ticket to the Gala Dinner & Presentation at the Hyatt Grand Ballroom for only $100.

Please complete the following form to order tickets to the 2021 Make Smoking History Targa West Gala Dinner (supported by the City of Perth)

Tables can seat up to 10 people.

Name *

Email *

Mobile *

Number of Tickets @ $100 each *

Please select how many tickets you require.

Dietary Requirements

Please advise of any special dietary requirements.

Payment Type *

Please select your preferred payment method.

Direct Deposit (preferred)

Credit Card

Total Amount = $100

Total Amount = $200

Total Amount = $300

Total Amount = $400

Total Amount = $500

Total Amount = $600

Total Amount = $700

Total Amount = $800

Total Amount = $900

Total Amount = $1000

Direct Debit Details

BSB: 066-160
Account #: 10484606
Ref: Dinner & Name

Credit Card

Please contact admin@targawest.com.au to arrange a Credit Card Payment.

Please note a 1.5% Admin Fee applies to all Credit Card payments.

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