Registration for the Grand Civil War Ball

Lackawanna Historical Society - Registration Form for the
9th annual Grand Civil War Ball (Sat. April 13, 2013)
and Downton Abbey Fashion Show and Tea(Sun Apr 14, 2013)

Use this combined form to register for the Grand Civil War Ball and/or the Downton Abbey Fashion Show and Tea.
In order to save costs, tickets will not be mailed.
Instead, you should receive an email confirmation that we received your order.
Registration for the Downton Abbey Fashion Show/Tea MUST BE RECEIVED BY APRIL 10, 2013.
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.
- Downtown Abbey Fashion Show and Tea - $35 per person.

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

Description	Quantity and Price	Amount
Civil War Ball (single person registration)	_____ number of single people at $35 per person	______
Civil War Ball (registering as a couple)	_____ number of couples at $60 per couple	______
Downton Abbey Fashion Show and Tea	_____ number of people at $35 per person	______
	Total Amount Enclosed:	______

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!