Please print out this page, fill out completely and fax to: 631-224-5418
or mail to

Islip Arts Council

50 Irish Lane, East Islip, NY 11730

 

 

2010- 2011 CHAMBER MUSIC SERIES ORDER FORM

I wish to order tickets for the 2010-2011 Season

 

PLEASE SEND ____ SUBSCRIPTION(S) for all 4 CONCERTS @ $90. each subscription

 

 

_____Pacfica Quartet	Sunday, October 24 at 2 P.M.
_____Harlem Quartet	Sunday, November21 at 2 P.M.
_____Brass Roots Trio	Sunday, March 20 at 2 P.M.
_____Alexander String Quartet	Sunday, April 10 at 2 P.M.

         

 

 Name________________________________________________________________________

 

Address______________________________________________________________________

 

City_________________________________________ State___________Zip______________

 

Phone (Day)______________________________(Eve)________________________________

 

________Check Enclosed ______Charge my VISA/MASTERCARD/AMEX

 

Account No.____________________________________________ Exp. Date_______________

 

Signature ____________________________________________________________________

 

 

Do you have any friends who might like to join our series? Please list:

 

 

Name_______________________________ Address___________________________________

 

__________________________City________________________State_________Zip_________

{Do Not Write Below } FOR OFFICE USE ONLY

 

DATE RECEIVED_____________# SUBSCRIPTIONS ____________SEAT #_____________

 

RECEIPT #___________________ GUILD LEVEL_______________TOTAL $_____________

 

Thank you!

 

For more information, call 631-224-5420

or email us at info@islipartscouncil.org