Ticket
Order Form
2011 - 2012 Four-Concert
Series
Gravenhurst Opera House
_____ Adult Membership:
x $90 $________
_____ Student Membership:
x $30 $________
(17 &
under)
_____ Adult
Single:
x $30
$________
Oct 14 _____ Nov 26
_____
Feb 19 _____ May 4 _____
_____
Student Single:
x
$10
$________
Oct 14 _____ Nov 26 _____
Feb 19 _____ May 4 _____
Total:
$________
Donation: $________
(A receipt will be issued for a donation of $10 or more.)
Cheque
Amount: $________
(Please make
your cheque payable to Muskoka
Concert
Association.)
Name:
_______________________________________________
Mailing
Address: _____________________________________
______________________________________________________
Phone:
_______________________________________________
E-mail:
_______________________________________________
Please
mail to:
Muskoka
Concert Association
810
Muskoka Beach Road, Gravenhurst,
ON,
P1P
1A7