MAIL IN FORM FOR GUNS & HOSES 2
JANUARY 10, 2009
7 PM Cocktail Party * 8 PM Showtime!
The Jeanne Rimsky Theater * 232 Main Street Port Washington, New York
First & Last Name:_________________________________________________
Street Address:___________________________________________________
City , State & Zip:_________________________________________________
Email (NEEDED FOR CONFIRMATION):_______________________________________
Contact Phone Number:_____________________________________________
_________ Qty @ $25.00 each Group Sale Discount (MUST BUY 10 or More)
_______ Qty @ $30.00 each General Admission Seating PLUS Open Bar Reception
_______ Qty @ $75.00 each VIP Seating PLUS Reception PLUS VIP GIFTBAG
We cannot attend, but please accept our donation in the amount of $ ___________________
Total Enclosed: $_________
Credit Card Purchases : Circle VISA or MASTERCARD
Account Number:_____________________________________
Expiration Date: __________________________________
Make checks payable and mail to :
Friends of The Elija School
665 N. Newbridge Rd
Levittown NY 11756
LIST ALL THE NAMES OF ATTENDEES HERE: _______________________________________________________________
___________________________________________________________________________________________________________
Call us for questions 516 433 4321
