Alumni & Friends Theatre Evening at Lac Brome  

August 17, 2006.

Registration Form

This is a secure site.

  Yes, I/we will attend the play only and pick up my ticket(s) at the box office

  Yes, I/we will attend the play and pre reception and pick up my ticket(s) at the Godber’s

Number of Tickets: 

Name(s) & Grad Years (if applicable):

Phone Number:

 

Payment Options:

Option A)    VISA  MasterCard  American Express

Card Number:

Expiry Date:

Amount:

Name on Card: 

B)  I will contact the Alumni & Development Office with my
           payment at 819-822-9660.

E-mail: