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Spend the day in Vermont, Not in the car. |
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MHCA P.O. Box 1720
Wilmington, Vermont 05363 802-464-8411
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ORDER FORM – 2013 SEASON
This form is the most efficient way to order tickets this year. If you have questions, please call Dan @
802-464-8541 after 10 am and before 9 pm, and I will return the call in the evening or next morning if I am not available. Please note: All performances are general admission this year.
Name ______________________________________________
Address ____________________________________________
____________________________________________
City __________________________ State ______________ Zip __________________
Phone: ______________________email: __________________________________ (to confirm the order)
Events order: [for GALA, please indicate entrée choice(s)]
Date # of Tickets Type
(Person/student)
Floor/Balcony
(if applicable)
Price Total for Event
for GALA______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ ______ ______________ _________________ ________________ ______ _______ I wish tickets to be sent by mail to above address. (if not, tickets will be held in above name for will-call night of the event)
MEMBERSHIP Contribution: _______ Total payable by check to MHCA, Inc.,
Please send to P.O. Box 1720, Wilmington, VT 05363_______
OR Please provide full credit card information for: Visa, MasterCard or American Express. (circle type)
Full name as it appears on card. _____________________________________
Address registered for card ___________________________________________________________
City______________________ State ______ Zip _______________
Card # _____________________________________ Expiration: Month _______ Year_______
Security Code _________________
Thank you for your order!