DEPOSIT FORM

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First Name: *

Last Name: *
Booking or Company Name: *
Email: *

Phone: *
Booking Ref No:

Venue: *
Booking Date (dd/mm/yyyy): *

Booking Time: *

For Christmas Lunch Bookings, please contact us to confirm availability
No. Of Adults: *

No. Of Children:
Amount to be charged: *
( Deposits / Full Payments )

Menu selection & price per person:
Credit card
Card Holder Name *

Card Number *

Expiry (MM/YY) *

Card Code *
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NICK’S RESTAURANT AND BAR GROUP

T: 1300 989 989
F: (02) 9264 8448
info@nicksgroup.com.au