Cannonball House & Car Tour Registration Form

Name: ___________________________________________________

Telephone: ________________________

Mailing Address: _____________________________________________

City/State/Zip: _______________  __________  _________

E-mail: _____________________________                      

Saturday June 7th

House Tour from 2-6pm

ACWC Open Car Show from 10am-4pm

 House Tour Ticket: $35/ticket

_____ (Number of Tickets) x $35 = ________ Total Due

 Member Ticket: $25/ticket

_____ (Number of Tickets) x $25 = _______ Total Due

(You must be a current ACWC Member to use a discounted Member Ticket)

 Show a Car: $10/car with purchase of a House Tour Ticket
Those who purchase House Tour Tickets will be given spots first.
Car Information:
Year of Car: ________ Make/Model of Car: _______________________
Group Affiliation: ___________________

Call the Arts Council to reserve your spot now.

Pay with your credit card (over the telephone or with the below form) or send a check or money order with this form.

Signature:  _____________________________       Date: ______________________________

Amount Enclosed:  ____________________

Credit Card Information:

Name (if different from above): _______________________________________________
Select Payment Type:  Visa  Master Card
Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiration Date: ___/___

Mail to: The Arts Council for Wyoming County  P.O. Box 249, Perry, NY 14530

585-237-3517 info@artswyco.org  www.artswyco.org