Registration for the Grand Civil War Ball

Lackawanna Historical Society
Registration Form for the
4th annual Grand Civil War Ball
Saturday April 19, 2008

Use this form to register for the Grand Civil War Ball only.
In order to save costs, tickets will not be mailed.
Instead, you should receive an email confirmation that we received your order.
The Grand Civil War Ball was sold out last year, so please register as soon as possible for the ball.
Costs: The Grand Civil War Ball is $35 if you are registering as an individual (no partner),
or $60 if you are registering as a couple.

Description	Quantity and Price	Amount
Grand Civil War Ball (single person registration)	_______ number of single people at $35 per person	_______
Grand Civil War Ball (registering as a couple)	_______ number of couples at $60 per couple	_______
	Total ---->>	_______

Send this form along with a check made payable to:

Lackawanna Historical Society - Civil War Ball
232 Monroe Ave., Scranton, PA 18510

Thank You for your support!