Name:
Email Address:
Phone Contact:
Will you be attending the Wreath Laying? Do you need a Chaplet?
No
Yes I have my Own Wreath
Yes I'd like to order a £20 Chaplet
How many attendees?
1
2
3
4
5
6
7
8
9
10
11
12
Will you be attending the Community Tribute Dinner for Robert Burns?
No
Yes £30 per head
How many attendees for Dinner?
1
2
3
4
5
6
7
8
9
10
11
12
Do you have any dietary needs?( i.e Vegetarian Haggis)
Anything Else: (i.e Comment)
form mail