Effingham Performance Center
Student Performances Reservation Form
School Name
________________________________________________
Contact Person
________________________________________________
Title
___________________________________________________________
Mailing Address ___________________________________________________
City, State, Zip Code _______________________________________________
Day Phone ____________________
Alternate Phone _________________
Email Address _____________________________________________________
Preferred Method of Contact _______ Mail _______ Phone _______ Email
Student Grade Level(s) _____________________________________________
Select Performance(s)
_______ We the People (Oct. 24,2016)
________ Tickets
_________ The Lion, the Witch, and the Wardrobe(Dec.7, 2016) ________ Tickets
_________Bing, Bang, Boom! - Science Show (Mar. 1, 2017)
_________Choosy Suzy’s Bully Prevention Show
________ Tickets
(Apr. 27, 2016)________
Tickets
Tickets are $6.00 each. Your invoice will reflect one complimentary ticket for every 15 paid tickets.
You will receive an agreement upon receipt of this form. Your reservation will be confirmed when you return the
agreement with agreed upon deposit of 25%. Check (payable to ACCI) or credit card payment is accepted.
Final payment is due 30 days prior to the performance. After that date, payment is due at the time of
reservation and seats are subject to availability.
We the People
Final Payment Date – September 26, 2016
The Lion, the Witch, and the Wardrobe
Final Payment Date – November 7, 2016
Bing, Bang, Boom – Science Show
Final Payment Date – February 1, 2017
Choosy Suzy’s Bully Prevention
Final Payment Date – March 27, 2017
Please note: You will be charged for all seats in your order.
Any changes to your order must be made in writing or via email to [email protected]
Mail, phone or fax your reservation to:
Effingham Performance Center :: 1325 Outer Belt West :: Effingham, IL 62401 :: 217.540.2788 :: fax 217.540.2789