Hilton Birmingham Metropole, NECFriday 10th February 2012

Champagne receptionFive course meal with wine & liqueursComedian – Simon EvansDancing to top band – Hot StuffCharity raffle

Tickets: £85 + VAT per person for bookings received with payment before 31.10.11

£95 + VAT per person for later bookings

(Bookings accepted for tables of 10 or individual places)

Comedian Simon Evans

Music Hot Stuff

Sponsored by

Friday 10th February 2012

Please fax this completed form to Claire Pitt, SBGI Events & Projects Manager on 01926 511923, post it to her at Camden House, Warwick Road, Kenilworth, Warwickshire CV8 1TH or email it to claire@sbgi.org.uk

My company wishes to reserve: tables for 10 @ £850 + VAT (£950 + VAT if booked after 31.10.11)

places @ £85 + VAT per person (£95 + VAT if booked after 31.10.11)

*We prefer to be located: near to dance floor and stage at a distance from dance floor and stage no preference

*Please tick as applicable - allocation in order of receipt of bookings

PAYMENT DETAILSBooking Fee:Tables for 10: to 31.10.11 * £1020.00 (£850 + VAT) After 31.10.11 * £1140.00 (£950 + VAT)

Individual places: to 31.10.11 * £102.00 (£85 + VAT) After 31.10.11 * £114.00 (£95 + VAT)

*Please tick relevant box.

I authorise the total payment of £ .......................................................... (incl. VAT)

PAYMENT METHODBy cheque payable to SBGI (enclosed) (Payment must accompany booking)

Mastercard Visa Card Number:

Start Date: Expiry Date: Issue No: Security Code:

(if applicable) Last 3 digits on back of card. This is mandatory to process your card.

Exact name on card: Signature of Card Holder:

BOOKER DETAILS

Contact name: Company:

Address:

Tel (Direct Dial): Fax:

Email:

Company Name and address for invoicing if different from above:

Cancellation policy: In the event of cancellation of your booking: -Not later than 31/12/11: full refund less £10 admin charge per person -Not later than 20/01/12: 50% refund - After 20/01/12: no refund

A confirmation letter and VAT receipted invoice will be sent to you, along with details of specially discounted accommodation rates at the Hilton Birmingham Metropole Hotel.