2004- 2005 Ticket Order Form

INSTRUCTIONS Type in your information and print the form     or     Print the form and then fill it in. Mail your completed order form with your Check or Credit Card information to: Thayer Symphony Orchestra 14 Monument Square, Fourth Floor Leominster, MA 01453

Email Questions to: programs@thayersymphony.org

To call or Fax order in: Contact Us

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CONTACT INFORMATION                Renewing Subscriber           New Subscriber
First Name:		Last Name:
Address:
City: State: Zip Code:
Telephone:	Day: Evening:
Email Address:
FULL SEASON Enjoy the entire 6 Concerts of the Series
Order Quantity per Series: Price per Series: Extended Cost: Quantity: "A" Seats at $150 = $ Quantity: "A" Seats Senior / Student rate at $138 = $ Quantity: "B" Seats at $132 = $ Quantity: "B" Seats Senior/ Student Rate at $120 = $ SubTotal:     $
Ticket Info / Seating Chart Top View Concert Schedule
PIZZA and SYMPHONY Join us for a special fun and educational program.     Followed by the dress rehearsal
Please select the date(s) you plan to attend:
Oct. 28
No. Adults at $8 each  x   No. of events:         = $ No. Children at $6 each  x   No. of events:         = $ SubTotal:     $
See Pizza & Symphony for more information.		Top
SINGLE CONCERT SERIES
"A" Seats: Regular $25 each Senior / Student $23 each "B" Seats: Regular $23 each Senior / Student $21 each Dec 12, 1:00 pm only Adults $18 each Children $12 each
Sept. 25 Quantity: Seats at     $        = $ Oct. 30 Quantity: Seats at     $        = $ Dec. 11 Quantity: Seats at     $        = $ Dec. 12, 1:00 pm Quantity: Seats at     $        = $ Dec. 12, 4:00 pm Quantity: Seats at     $        = $ Feb. 12 Quantity: Seats at     $        = $ Apr. 02 Quantity: Seats at     $        = $ May 7 Quantity: Seats at     $        = $ SubTotal:     $
Ticket Info / Seating Chart Top View Concert Schedule
CONTRIBUTIONS
Because ticket prices cover less than 50% of concert expenses, I would like to make a contribution of: $
My employer will match my contribution.		My employer match form is enclosed.
Contributions to the orchestra are very much appreciated and are tax-deductible. Thank you for your support! Contributors of $10 or more will be listed in our 2005 - 2006 Program Book.
I'm delighted to make a contribution, but do NOT wish to be listed in the Program Book.
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GRAND TOTAL Please add dollar amounts from all events, and enter your Grand Total Due below. Full Season Tickets: $ Single Concert Tickets: $ Holiday Matinee Tickets: $ Pizza & Symphony Tickets: $ Contributions: $ Grand Total: $ Top
PAYMENT OPTIONS Check or Credit Card
Check enclosed (payable to: "Thayer Symphony Orchestra")     or     Please charge my: MasterCard Visa Discover American Express Card No.: Expiration Date: Name on card: Signature: X       Your signature is required for credit card orders. Top