Advance Ticketing Order Form
The Portland Megaband Dance
Saturday, March 10, 2012 8:00 PM (teaching session at 7:30 PM)

1. Print this form and provide all information requested.
   (Or write out the same information in full.)

2. Write a check for the full amount payable to PCDC.

3. Required! Please enclose a Self Addressed and Stamped Envelope (SASE) to be used to return the tickets to your address.

Your tickets will be returned to you promptly in your SASE.

Ticket orders must be postmarked on or before February 28, 2012.

Mail this form, your full payment check,
and the SASE to:

Megaband Ticketing
Lanny Martin
4405 SW Redondo
Portland, OR 97239-1389

Please provide the following contact information:

Name
Street Address
City
State/Province
Zip/Postal Code
Day Phone
Evening Phone
E-mail

Please provide the following ordering information:

For Members* of these music organizations	Quantity		Sub - Total
		$12.00/ticket=	$
		$12.00/ticket=	$
General Admission		$15.00/ticket=	$
Seniors and Students with ID		$9.00/ticket=	$
Total Number of Tickets Ordered		Total Paid=	$

*Member tickets are for active members of PCDC, PFS, or other dance and/or community music organization.
Make your check payable to PCDC