Please print this page and mail to: Bob Blonowicz, 24 Clover Park Dr., Apt. 2, Rochester, NY 14618

Don't forget to enclose a self-addressed, stamped envelope and a check or money order for the total amount.

SAVE!!! Pre-order your tickets by mail for $10 each - $12 at the door!!

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ORDER FORM - please print

I would like ______ tickets at $10 each. Enclosed is a check for $_______.

Name ____________________________________________________________________

Address __________________________________________________________________

City____________________________________ State ______ Zip ___________________

Email ____________________________________________________________________

$1 FROM EACH TICKET WILL BE DONATED TO BREAST CANCER COALITION

OF ROCHESTER.

 

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