Print the form (use icon at right), fill out and mail with Credit Card information or Check (made out to Nevada Opera) by November 5th to Jukebox, P.O. Box 3256, Reno, NV 89505
| Name(s) |
_____________________________________________________________________________________________________________________ |
# Individuals@ $95
|
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#Couples @ $175 |
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Table @ $650 |
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Total |
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| # Raffle Tickets @ $20 |
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# 3-Ticket Sets @ $50 |
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Total |
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We will fill out the ticket(s) for you and submit for the drawing
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Total Due
|
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| Credit Card Number |
_________________ |
Expires |
___/___ |
Security Code |
_____ |
| Email |
_____________________________________________________________________________________________________________________ |
Full Address
|
_____________________________________________________________________________________________________________________ |
Phone
|
( ) Cell Phone: ( ) |
Jukebox Form
