Fundraiser Entertainment Night

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Syria Fundraiser Entertainment Night

Thank you for your interest in attending the Syria Fundraiser Entertainment Night hosted by University of Melbourne Islamic Society and La Trobe University Islamic Society. To confirm your attendance, please fill out the information below. Payment of $15 for admission is to be paid on the night.

* First Name

* Last Name

Title

* Mobile/Home Phone

* Email Address

* Confirm email address

Include my contact information on UMIS and LTUIS mailing lists for future events

Yes

No

* Number of tickets

Additional Information

* Indicates Response Required