ACT I
of Benton County
1999 - 2000 Order Form
PLEASE
PRINT THIS PAGE
FILL IT OUT
SEND IT IN WITH YOUR CHECK
to
ACT I of Benton County
Membership Subscriptions
Box 222
Vinton, Iowa 52349
Your season ticket packets will then be delivered to you!
Name ____________________________________________
Address __________________________________________
Phone Number _______________ E-mail address ___________________
We wish to purchase the following:
___ $35.00 Adult Season Tickets for $ ____________
___ $25.00 Student Season Tickets for $ ____________
___ $10.00 KidTix season tickets for $ ____________
___ voting memberships ($10.00 each, free with season ticket)
___ $5.00
Grease Paint Snail Mail Subscription, or $6.00 when
purchased without Season Ticket (free online)
___
Palace Theatre Commemorative Book
($10.00 -- available in December)
$ ____________
Tax deductible contribution $ __________________
Total order: $ __________________