Registration for the Grand Civil War Ball and/or Dance & Dress in High Society

Lackawanna Historical Society
Registration Form for the
5th annual Grand Civil War Ball, Sat Apr 18, 2009 and/or
Dance & Dress in High Society on Sun Apr 19, 2009

Use this combined form to register for the Grand Civil War Ball and/or Dance & Dress in High Society.
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.
Advance registration required for Dance & Dress in High Society (Victorian Tea, Dance Demo, and Lecture) in order to give the caterer an accurate count of those attending. No tickets sold at the door for the Sunday event.
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.
Dance & Dress in High Society is $30 per person before April 5th / $35 per person after April 5.

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	_______
Dance & Dress in High Society (Victorian Tea, Dance Demo, & Lecture)	_____ number of people at $30 per person ($35 after Apr 5)	_______
	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!