Gala Ticket Order Form

Gala Preview Event, November 18, 2011 6pm

TICKET ORDER

# tickets: ______  x $40 = _______________

PAYMENT ENCLOSED

______Check  _______Visa  ______MasterCard

Card #_________________________________

Exp Date____________  CVC (3 digits from back of card)________

Signature_________________________________________

 

MAIL TICKETS TO:

Name________________________________

Address______________________________

City____________________ State_______ ZIP_______

Telephone____________________________

Email Address__________________________

Would you like to receive updates by email as they become available? _________

Mail completed form to:  Celebration of Seagrove Potters Tickets, Box 309, Seagrove, NC 27341