STEP 1: Contact Information
STEP 2: Patrons Association
(optional)
Choose your level of membership:
Name:
Angel
Director
Benefactor
Friend
Address:
City/State/Zip:
Home Phone:
$1,000 (up to 8 subscriptions at the Patron rate)
$500 (up to 6 subscriptions at the Patron rate)
$250 (up to 4 subscriptions at the Patron rate)
$150 (up to 2 subscriptions at the Patron rate)
Work Phone:
E-mail:
Print your name as you want it to appear in the program
STEP 3: Choose Your Subscription
e
iv
a
C
.
Patron
____
@$8
____
@$12
____
@$12
____
@$17
___
@$17
_____
@$17
____
@$13
____
@$17
____
@$17
____
@$15
____
@$15
____
@$15
____
@$13
____
@$15
____
@$15
.
____
@$12
.
____
@$12
.
Senior
____
@$12
\
Adult
Special Seating Requests:
Totals
n
ro
ig
tP
Fa
pe
ha
OR
r
ise
M
e
Th
e
Be
g
lin
el
kie
Sp
oo
o.
C
C
A
am
se
op
tn
St
ou
s
Pu
M
Bu
e
G
$68
$98
$88
$51
Subtotal $
sy
w
ro
D
Patron
Adult
Senior
Student**
e
Th
Level
Option #2 (choose at least 4 shows)
Option #1 (includes all 6 shows)
Quantity
Price
Total
.
Subtotal $
**Some Shows may not be suitable for students of all ages.
STEP 4: Circle Your Preferred Dates and Times
Fat Pig*
The Drowsy Chaperone
Bus Stop
The Lab Theatre (General Admission)
The Fallon Theatre (Reserved Seating)
The Lab Theatre (General Admission)
September/October 2010
October 2010
November 2010
Wed
Thu
Fri
30
1
7:30PM 8PM
Sat
2
8PM
Sun
3
2PM
Wed
Thu
Fri
21
22
7:30PM 8PM
Sat
23
8PM
Sun
24
2PM
Wed
Thu
Fri
4
5
7:30PM 8PM
Sat
6
8PM
Sun
7
2PM
6
8PM
7
8PM
9
8PM
10
2PM
27
8PM
28
8PM
30
8PM
31
2PM
10
8PM
11
8PM
13
8PM
14
2PM
8
8PM
The 25th Annual Putnam
County Spelling Bee
The Fallon Theatre (Reserved Seating)
February 2011
Wed
Thu
Fri
10
11
7:30PM 8PM
Sat
12
8PM
Sun
13
2PM
16
8PM
17
8PM
19
8PM
20
2PM
18
8PM
The Miser
12
8PM
STEP 4A: New Horizons*
The Lab Theatre (General Admission)
February/March 2011
Wed
Thu
Fri
24
25
7:30PM 8PM
Sat
26
8PM
Sun
27
2PM
2
8PM
3
8PM
5
8PM
6
2PM
4
8PM
Quantity
Pass
Price
$25
Total
$
Shaded dates are Patrons Nights
*Contains Mature Content
The Fallon Theatre (General Admission)
November 2010
Wed
17
7PM
Thu
18
7PM
Fri
19
7PM
Sat
20
2PM
7PM
Totals
$
Tickets (steps 3 & 4)
$
New Horizons
$
Handling Fee
$3.00
TOTAL
$
Check # _________
Checks payable to:
FSU - tickets only
FSU Foundation
w/donation
AmEx
Discover*
MasterCard
Visa
FSU Card
Card #
Signature
Sun
21
2PM
7PM
FOR OFFICE USE ONLY R’cvd _____/_____
Acct# ___________
Excel _____/_____
CTS
_____/_____
FD
_____/_____
Print _____/_____
Mailed_____/_____
STEP 5: Choose Payment
Donation (step 2)
(step 4A)
29
8PM
If You Give a Mouse A
Cookie
Exp.
*We cannot process orders that include donations on a Discover Card