QUABOAG HIGHLANDERS PIPES & DRUMS

2009 CELTIC BALL TICKET ORDER FORM

 Mr/Mrs/Ms          First  Name                             Last Name

    Street  Address

  Town/City                                                         State          Zip Code

  Primary Phone    Home Phone Cell Phone Work Phone

  Email Address    

Meal Selections

Please indicate total numbers for each: 

     Roast Prime Rib:               0 1 2 3 4 5 6 7 8

                                   Chicken Francaise:            0 1 2 3 4 5 6 7 8

                                  New England Scrod:           0 1 2 3 4 5 6 7 8

                                  Vegetarian:                         0 1 2 3 4 5 6 7 8

                                                 Total # of tickets    0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 @ $50.00 each

                                Amount enclosed  $             Please make checks payable to

                                                                                                Quaboag Highlanders

  Special Seating Requests Or Meal  Requests

Your tickets will be sent to you along with directions to the Springfield Sheraton.

.

Please Print & Mail This Form

along with your payment To:

Quaboag Highlanders Pipes & Drums

2009 Celtic Ball

 P.O. Box 541

Monson, MA  01057

Any Questions: Please call   (413) 205-8335

Thank You for Your Support