DATE_________

SINGLE TICKET ORDER FORM

NAME: _________________________________________________________

First Last

ADDRESS:______________________________________________________

CITY: ______________________ STATE: ________ ZIP: _______________

PHONE: ______________________ __________________________

Home Work

CONCERT #OF TIX PRICE TOTAL

Regina Carter _______ $30 $______

Robert Glasper Trio _______ $25 $______

Trombone Shorty _______ $25 $______

Thunder from the Heartland _______ $20 $______

Orchestre National de Jazz

Around Robert Wyatt _______ $10 $_______

Dave Sterner Quintet _______ $10 $________

SUBTOTAL: $________

DISCOUNT (Senior/Student less $3 per ticket) $________

$2 PROCESSING FEE PER TICKET $________

GRAND TOTAL: $________

______ Master _______-___________-______________ exp _____ 3 digits______

______ Visa _______-___________-______________ exp _____ 3 digits______

______ Discover _______-___________-_____________ exp _____ 3 digits______

______ Am. Exp ___________-___________-____________exp _____ 4 digits______

ALL SALES FINAL – NO REFUNDS OR EXCHANGES

CHECKS ARE NOT ACCEPTABLE

Dee Dee Bridgewater &

The Cleveland Orchestra ORDER SINGLE TICKETS THROUGH SEVERANCE HALL

Smooth Jazz All-Stars ORDER SINGLE TICKETS THROUGH PLAYHOUSE SQUARE

Medeski Martin & Wood ORDER SINGLE TICKETS THROUGH PLAYHOUSE SQUARE

Smokey Robinson ORDER SINGLE TICKETS THROUGH PLAYHOUSE SQUARE