Ballot Form

Contact Information

Chairman’s Club Membership Name or Company Name (if applicable)

Contact Name *

Contact Email *

First Preference

Host Name *

Preference Reason *

Additional tickets required *

Maximum 15

Total number of guests *

Second Preference

Host Name *

Preference Reason *

Additional tickets required *

Maximum 15

Total number of guests *

Third Preference

Host Name *

Preference Reason *

Additional tickets required *

Maximum 15

Total number of guests *

Fourth Preference

Host Name *

Preference Reason *

Additional tickets required *

Maximum 15

Total number of guests *

Declaration *

I agree for myself and on behalf of the Company (as applicable) to be bound by and comply with, and shall notify and require my guests and invitees to abide by, the Membership Terms and Conditions and The Chairman’s Club Terms and Conditions here.

Yes, I give permission to store and process my data *