All-Purpose Order Form

Print this form and mail it with your check to order tickets and to make contributions.
 

NAME:

STREET:

APT:

STREET 2:

CITY:

ST:

ZIP:

PHONE - DAY:

EVE:

EMAIL (IMPORTANT!!):

TICKET ORDER

_____ADULT TICKETS @ $25.00 ea.

TOTAL $
_____STUDENT TICKETS @ $5.00 ea. TOTAL $

_____2009-2010 SERIES @ $100.00 ea.

        Booklet of 5 tickets (One concert free)

TOTAL $

 

TICKET TOTAL $

CONTRIBUTION

Sponsor

$1,000 and above

Benefactor

$250 to $999

Patron

$100 to $249

Friend

up to $99

 

CONTRIBUTION $

 

TOTAL ENCLOSED $

PRINT OUT AND MAIL THIS FORM AND YOUR CHECK TO:
Rhinebeck Chamber Music Society, Inc.
P.O. Box 465
Rhinebeck, NY 12572-0465