Please print out this page, fill out completely and fax to: 631-277-1342
or mail to

Islip Arts Council

50 Irish Lane, East Islip, NY 11730

 

 

2011- 2012 CHAMBER MUSIC SERIES ORDER FORM

I wish to order tickets for the 2011-2012 Season
 

PLEASE SEND ____ SUBSCRIPTION(S) for all 5 CONCERTS @ $100. each subscription

 

 

_____McDermott Trio & Friends with Paul Neubauer, Violist
Sunday, September 25 at 3 P.M.
_____Colorado Quartet

Sunday,October 23 at 3 P.M.

_____KammerConnect Sunday, March 11 at 3 P.M.
_____Serenade Duo & Friends with Matthew Pierce String Quartet Sunday, April 1 at 3 P.M.
____McDermott Trio & Friends with Tara O'Connor, Flutist Sunday, Aprill 22, 2012 at 3 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