Here is my full payment of $_________ for 2010 Eisteddfod tickets.
all festival pass;
___ non-members
@$115 ea, ___ members @$105 ea, ___ child/student @$55 ea.
=$________
Friday (concert only);
___ non-members
@$30 ea, ___ members @$25ea, ___ child/student @$15 ea.
=$________
Saturday (incl. concert);
___
non-members @$70 ea, ___ members @$65 ea, ___ child/student
@$35 ea. =$________
Saturday (concert and dance only);
___
non-members @$30 ea, ___ members @$25ea, ___ child/student
@$15 ea. =$________
Sunday (incl. concert);
___
non-members @$50 ea,
___ members @$45 ea, ___ child/student @$25 ea. =$________
Meals: ____ Friday Dinner @ $20 = $_______
Saturday Meals: ___Breakfast @ $12, ___Lunch @ $15, ___Dinner @ $20 = $_________
Sunday Meals: ___Breakfast @ $12, ___Lunch @ $15 = $_________
If ordering meals, please indicate any dietary restrictions:
[ ] vegetarian; [ ] vegetarian eats fish;
[ ] vegan; [ ] no red meat; [ ] no
poultry; [ ] no fish; [ ] no dairy; [
]other(explain:____________________________________________)
[ ] I wish to help support the Eisteddfod; my check includes an additional $_________. (Additional contributions are tax deductible, as permitted by law.)
Name___________________________________ Phone day (____ )________________;
Address__________________________________, eve (____)_____________________
City___________________________ State _____ ZIP ________________
E-Mail: ___________________________________
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