PixelGood.® Web Feature
Design is in the Details.®
Required fields are marked with an
*
Ticket orders are available by credit card purchase only! Ticket prices are $50 each, and tables of 8 and 12 are available.
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Method of Payment:
Visa
MasterCard
Discover
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Card #:
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Exp. Date:
Month:
01
02
03
04
05
06
07
08
09
10
11
12
Year:
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
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Number of Tickets to Purchase:
01
02
03
04
05
06
07
08
09
10
11
12
@ $50 per ticket
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Meal Options
For your convenience, a vegetarian meal option will be available and you may make this selection by checking the box below:
Vegetarian Meal
Additionally, please indicate any dietary restrictions or concerns you may have in the space provided below:
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Name:
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Address:
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City:
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State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
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Zip:
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Country:
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Phone:
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E-Mail:
If you have worked at WKSU at any time during the past 50 years, please indicate the appropriate era in which you worked from the pulldown menu below:
1950s
1960s
1970s
1980s
1990s
I have never worked at WKSU
If you are not bringing any guests, you may skip this section and “submit your order.” If you are bringing one or more guests, please continue by filling in their name(s) in the spaces provided. When you are finished, click “submit your order” to complete your transaction.
2.
Name:
Vegetarian Meal
3.
Name:
Vegetarian Meal
4.
Name:
Vegetarian Meal
5.
Name:
Vegetarian Meal
6.
Name:
Vegetarian Meal
This is a
SECURE
transaction. Click the button
ONE TIME.
Just ONCE is all it takes to send us your completed ticket order form.
