Community Arts in Action

PLEASE PRINT OUT THIS FORM AND MAIL, WITH CHECK, TO:

Community Arts / S. Monaghan
111 Pineview Terrace
West Wareham, MA 02576

Community Arts in Action
www.WarehamArts.org

Please mail this form with your check payable to Community Arts in Action to:

Community Arts / S. Monaghan
111 Pineview Terrace
West Wareham, MA 02576

Name:
Address:

City:
State:
Zip Code:
Telephone:
Email:
Performance Date:
General Admission Tickets:		x $20.00 =	$
Adults Over 55 Tickets:		x $10.00 =	$
Child Tickets:		x $5.00 =	$
Total:
Please check if you would like your tickets:	Mailed to the address listed above Held at the venue
How did you hear about this performance?