DYLAN DAYS 2010 BUS TOUR ORDER FORM

NAME

MAILING

ADDRESS

CITY, STATE

OR PROVINCE

POSTAL

CODE

DAYTIME

PHONE

	QUANTITY ORDERED	UNIT PRICE	TOTAL AMOUNT
BUS TOUR TICKET (INCLUDES BUTTON)		$15.00	$
CREDIT CARD FEE ($0.50 PER TICKET, IF CHARGED)		$0.50	$
	----------------	-------------	---------------------------
GRAND TOTAL	--------	------	$

MAKE CHECKS PAYABLE TO:  DYLAN DAYS, HIBBING, MN

Orders must include check or valid credit card number to be processed.

CREDIT CARD NUMBER (VISA – MASTERCARD – DISCOVER):    

-

-

-

EXPIRATION MONTH AND YEAR:    

/

Bus Tour is Saturday, May 29, 2010 from 10:30 a.m. – 2:30 p.m.  Tickets will be held at Zimmy’s.  The bus departs promptly at 10:30 from Zimmy's and will return there afterward.

PRINT THIS FORM AND MAIL OR FAX IT TO ZIMMY'S:

Fax number: 218-262-3205

Mail:
Dylan Days bus tour tickets
531 E. Howard St.
Hibbing, MN  55746