Booking Form for HSO Concerts

Name:............................................................................................................

Address:.................................................................................Postcode............

Telephone:................................Email:.............................................................

Do you want to join our mailing list?      Yes     /      No

CONCERT		Adult	Conc.*	Child ^	Family <	Total $
1	A Res
	B Res
2 (Sat)	A Res
	B Res
2 (Sun)	A Res
	B Res
3 (Sat)	A Res
	B Res
3 (Sun)	A Res
	B Res
4	A Res
	B Res
Subscription (All 1-4) check boxes to indicate concert dates required	A Res
	B Res
Processing fee						$2.00
Would you like to add a Tax Deductible Donation?
					Total

*Please complete the following details regarding your concession card

Concession card Type .......................................................... 

Concession Card Number  .............................................

(for additional persons, please provide details on a separate sheet and attach to this booking form).

Payment Method (please circle one)

Cheque  (made payable to Heidelberg Orchestras Inc.)         Visa         Mastercard

Cardholder's Name:........................................................................................

Card No. | _  _  _  _  |  _  _  _  _  |  _  _  _  _  |  _  _  _  _ |    Expiry  ___ / ___

 

Signature:..............................................................................................

Please return this form with stamped self-addressed envelope (for return of tickets) to:

The Concert Manager
Heidelberg Orchestras Inc.
36 Kurrajong Cres.
North Watsonia Vic. 3087