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| Count Basie Theatre Ticket Order Form Print and complete the Ticket Order Form and FAX to: 732-842-9323 (using your credit card information). To order by mail (with your check or credit card information), send the completed Ticket Order Form to Count Basie Theatre Box Office, 99 Monmouth Street, Red Bank, NJ 07701. A $4 per ticket service fee applies to all mail and fax orders. Please note: If you are paying with a check, it is required that you write your phone number and drivers license number on the check. If we receive your check without the phone number and drivers license number, we will be forced to return your check to you so you can add the information and send it back. We do not hold seats. All mail orders are filled on a first come, first serve basis with whatever is best available in the price range you've selected. Name _____________________________________________________ Address ___________________________________________________ City __________ State _______________ Zip ____________________ Phone _______________________ Email ________________________ Performance _____________________ Date _______________ Show Time ___________________ Tickets: Number of Tickets _____ x Ticket Price $ _____ = $ _____ Service Charge: Number of Tickets _____ x $4 per ticket = $ ____ I would like to support the nonprofit Count Basie Theatre with an additional tax deductible contribution of $ ______ Total Order $ _____ ___ I have enclosed a check in the amount of the total order. ___ Please charge my credit card __ Mastercard ___ VISA ___ Discover ___ American Express Card Number ________________________________________ Expiration date _____ Security ID# (Last 3 digits on the back of the signature panel) ______ Customer's Signature & Date (must accompany credit card orders) Signature: __________________________________________ Date:_______ All Sales Are Final. There Are No Refunds or Exchanges. * The Count Basie Theatre maintains an email list to notify patrons when new shows are added, and to provide a weekly summary of events. Participation is optional and subscribers can opt-out at any time. The Count Basie Theatre respects the privacy of its customers and donors and does not rent, sell, trade or exchange its mailing lists or databases. |
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