DEPOSIT FORM

First Name*
Last Name*
Booking or Company Name*
Email Address*
Phone Number*
Booking Reference No
Venue*
Booking Date*
DD slash MM slash YYYY
Booking Time*

: Hours

Minutes

AM/PM
No. Of Adults*
Please enter a number greater than or equal to 0.
No. Of Children
Please enter a number greater than or equal to 0.
Amount to be charged*

( Deposits / Full Payments )
Menu selection & price per person
Credit Card*

American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Terms and Conditions*
- I Agree to the Terms & Conditions
By ticking the above you accept the terms and conditions laid out here
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NICK’S RESTAURANT AND BAR GROUP

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