Assistance League: Sunset in the Vineyard Order Ticket Form


Name

Billing Address

City, State, Zip Code

Telephone (home)

Telephone (business)

E-Mail

Ticket Purchase Information

Number of tickets: __________ @ $55.00 each Total $__________ Cash q Check q

Please circle: Visa or MasterCard Credit card number: ____________________________

CVS number (located on back of card): __________ Expiration date: ________________

Authorized signature: ______________________________________________

Mail To:

ALSC – Sunset in the Vineyard

P.O. Box 220145

Santa Clarita, CA 91322 Federal Tax ID No: 95-4271779

(Event is on November the 8th from 3-6pm.)