September 27, 2014 - 7 PM
Ticket Order Form
(Please print)
Name:_____________________________________________ Mem. # _________
Address:_______________________________________________________
City:________________________________________ State: ____ Zip:___________
Phone: Day ( ) __________________ Evening: ( ) __________________
email address __________________________________________
Remembering Dick Cerri - Saturday, September 27, 2014 - 7:00 PM
____ Box seat tickets @ $100.00 = $ ______
____ Front Orchestra tickets @ $90.00 = $ ______
____ Middle orchestra tickets @ $75.00 = $ ______
____ Rear orchestra tickets @ $50.00 = $ ______
____ Balcony tickets @ $60.00 = $ ______
____ Wheelchair Accessible @ $50.00 = $ ______
____ Reception tickets @ $35.00 = $ ______
TICKET TOTAL $ ______
I wish to become a FRIEND OF FOLK MUSIC
by making a tax-deductible $35 contribution
to the World Folk Music Association $ ______
Service Charge ($3.50 per concert ticket) $ ______
TOTAL AMOUNT DUE $ ______
METHOD OF PAYMENT: [ ]CHECK [ ]Credit Card Type:__________
Card # __________________________________________________ Exp. Date ___________
Signature: ______________________________________________ CSV#________
(only if using credit card) (3 digit dode on back of card)
Please send to:
WFMA, PO Box 83583, Gaithersburg, MD 20883.
Tickets will not be mailed.
All tickets may be picked up at the Clarice Smith Center Box Office beginning at 11 AM on September 27.
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