Autism Awareness Gala 2009

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Tickets Order Form

Please fill out the order form below to confirm your attendance.
Tickets will be mailed to the address you indicate on the form.

First Name:
Last Name:
Telephone:
Email Address:
Mailing Address:*
City:
Province:
Postal Code:
How many tickets will you be purchasing?	$85.00 each Total
Do you require a tax receipt? ($30)	No Yes
How do you want to receive your tickets?	Mail them please. Put on reserve, I will pick them up at the door on event night.
Any questions/comments?

* Please re-verify the address provided in order to insure proper delivery of your tickets.

Once you press the "Submit" button, you will be brought to our payment center where you will receive further payment instructions.