Central Pennsylvania Symphony
2011 – 2012 Ticket Order Form
| Print this form, fill out and send, with payment, to: |
The Central Pennsylvania Symphony
P.O. Box 55
Hummelstown, PA 17036 |
| Toll free telephone number: 717-910-0313 |
| Name(s): |
____________________________________ |
| Street Address or PO Box: |
____________________________________ |
| City: |
________________ |
State: |
____ |
Zip: |
_____ |
| Day Telephone: |
________-________-___________ |
| Evening Telephone: |
________-________-___________ |
|
| Halloween and the Trumpets! |
| Regular Ticket |
_____ X |
$20.00 |
= $________.00 |
| Senior Ticket |
_____ X |
$15.00 |
= $________.00 |
| Student Ticket |
_____ X |
$5.00 |
= $________.00 |
| Christmas with Cantate Carlisle |
| Regular Ticket |
_____ X |
$20.00 |
= $________.00 |
| Senior Ticket |
_____ X |
$15.00 |
= $________.00 |
| Student Ticket |
_____ X |
$5.00 |
= $________.00 |
| Giselle, a Ballet with the Central Pennsylvania Youth Ballet |
| Single Ticket |
_____ X |
$20.00 |
= $________.00 |
| Senior Ticket |
_____ X |
$15.00 |
= $________.00 |
| Student Ticket |
_____ X |
$5.00 |
= $________.00 |
|
| Annual Gala – Dancing With the Stars |
| Single Ticket |
_____ X |
$75.00 |
= $________.00 |
| One table 8 seats |
_____ X |
$500.00 |
= $________.00 |
| Please remit ONE check per table |
|
|
Donations |
| Underwriter ($3,000 and above) |
|
$________.00 |
Carolyn D. Ruhl Conductor
Sponsor $2,000 to $2,999) |
|
$________.00 |
D. Eugene Rannels Concertmaster
Sponsor ($1,000 to $1,999) |
|
$________.00 |
| Benefactor ($500 to $999) |
|
$________.00 |
| Patron ($100 to $499) |
|
$________.00 |
| Friend ($25 to $99) |
|
$________.00 |
TOTAL REMITTANCE ENCLOSED |
|
|
$________.00 |
|