
"CREATING ARTISTS, CONNECTING COMMUNITIES"
641-390-3155 info@cedarsummerstock.org
MAIL this FORM & CHECK to: CEDAR SUMMERSTOCK THEATER PO Box 182 St. Ansgar, IA 50472
Your Name_______________________________________________________________________________
Mailing Address___________________________________________________________________________
Email Address_________________________________________________________________________
Qty Subtotal
Adult Season Tickets $72 + $3 Handling Fee = $75 X ________= ________
Student Season Tickets $36 + $3 Handling Fee = $39 X ________= ________
*I WANT TO HELP kick-start the 2021 SEASON with a $________ tax deductible DONATION!
TOTAL DUE $________
____ ENCLOSED IS MY CHECK (Made out to: CEDAR SUMMERSTOCK THEATER)
____ CHARGE my Visa/MC/AmEx/Discover Card
CARD # ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ EXP-___ / ___ CW- ________
NAME ON CARD________________________________________________________________________
Billing Address_________________________________________________________________________
City/State/Zip__________________________________________________________________________
PLEASE PRINT MY NAME IN THE DONOR LIST AS FOLLOWS: