Fine Arts Theater
Season, Single performance ticket, and Online Giving Form

Please fill out the form below.
If you would like your name listed in the theatre program playbill, enter exactly how you would wish your name to be listed (below).
* Indicates required fields.
Name *
Street Address *
City *
State *

Zip

 *

Email address
For Tickets
Check all that apply:		  
 
Adult tickets ($10.00 each)  
 

Number of tickets:
  Total $:
  Performance
  Date
  Time
 
Student/Child tickets ($5.00 each)  
 

Number of tickets:
  Total $:
  Performance
  Date
  Time
 
Season tickets ($25.00 each)  
 

Number of tickets:
  Total $:
  Season:
For Season Tickets & Donations  

Exactly how do you wish your name
listed in the program?
For Gifts & Donations
Check all that apply:		  
  Alumni, Class of Business
  Alumni w/Student at USM, 
            Class of 		Friend
  Parent of a current
or former USM student		 Employed by a matching gift company-
      Company Name
Credit Card Information:
    Cardholder name (as it appears on the card):
*First Name
Middle Initial (if applicable)
*Last Name
*Type of card:
*Card number - - -
*Expiration date: (month)
Total
 *Amount to be charged to your card
(no commas, round to whole dollars)		 $
   
 
Security:  We use state-of-the-art secure server software (SSL) to prevent your valuable information from being tampered with or compromised in any way. The information you enter is encrypted before it is sent over the Internet, helping to ensure that the information you provide remains confidential.  


Thank you for your purchase or donation to the University of Saint Mary!