Parkland Institute Gala Fundraiser Dinner Ticket Form 6 pm, February 17, 2016 U of A Faculty Club Paid by: Name Address City Prov.. Table Name: Free seating (available for those who have not purchased in a group.) Total: Visa Paid by: Cheque (payable to University of Alberta) Master Card / Expiry Signature Charitable tax receipts will be issued for portion of the ticket..
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