All Fields Are Required (Unless Otherwise Noted)

No. of tickets to purchase @ $50 each:

Total Amount of purchase: $ Billing Information

This is your billing information as it appears on your credit card statement.

Billing Name:

Billing Address:

City:

State:

Zipcode:

Daytime Phone:

Cell Phone:

Email Address:

Are your billing & mailing addresses the same? Yes

Mailing Information

This is the address to which your ticket(s) and receipt will be mailed. If your order is
placed within 10 days of the event, tickets will not be mailed but will be held for
pick up at the door.

Mailing Name:

Mailing Address:

City:

State: Please select your state... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zipcode:

Credit Card/Payment Type: Please choose from below... Visa Mastercard Discover American Express Paypal

Additional Comments / Instructions:
Thank you for your support of the Museum and we'll see you February 17th!