| # | $ | Total Price |
|||
|---|---|---|---|---|---|
| Adult Series Subscriptions | ________ | x | ________ | = | ________ |
| Student/Senior Series Subscriptions | ________ | x | ________ | = | ________ |
| Individual Tickets | |||||
| Thursday, first weekend | ________ | x | ________ | = | ________ |
| Saturday, first weekend | ________ | x | ________ | = | ________ |
| Thursday, second weekend | ________ | x | ________ | = | ________ |
| Saturday, second weekend | ________ | x | ________ | = | ________ |
| Sub Total | ________ | ||||
| Additional Tax-Deductible Donation | ________ | ||||
| Total | ________ | ||||
| Name | _______________________________________________ |
|---|---|
| Address | _______________________________________________ |
| City/State/Zip | _______________________________________________ |
| Telephone | _______________________________________________ |
| Method of Payment | |
|---|---|
| _____ Check (payable to Portland Chamber Music Festival) | |
| _____ Credit Card: _____Visa _____MasterCard | |
| Card # _____________________________________ Exp Date ___________ | |
| Signature _______________________________________________________ | |