Registration for the Grand Civil War Ball and/or LHS Titanic Luncheon

Lackawanna Historical Society
Registration Form for the
8th annual Grand Civil War Ball, Sat. April 14, 2012
The LHS Titanic Luncheon, Sun. April 15, 2012

Use this combined form to register for the Grand Civil War Ball and/or the LHS Titanic Luncheon.
In order to save costs, tickets will not be mailed.
Instead, you should receive an email confirmation that we received your order.
Advance registration required for the LHS Titanic Luncheon in order to give the caterer an accurate count of those attending.
All tickets are non-refundable.

Costs:

Grand Civil War Ball	$35 if you are registering as an individual (no partner), or $60 if you are registering as a couple.
LHS Titanic Luncheon	$35 per person.

Name:	______________________________________________________________________
Address:	______________________________________________________________________
City, State, Zip:	______________________________________________________________________
Phone:	______________________________________________________________________
email:	______________________________________________________________________

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	_______
LHS Titanic Luncheon	_____ number of people at $35 per person	_______

Send this form along with a check made payable to:

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

All proceeds benefit the Lackawanna Historical Society.
Thank You for your support!