TICKET BOOKING FORM MELBOURNE VS PORT ADELAIDE SATURDAY JULY 16, 2011, TIO STADIUM 8.

10pm

PERSONAL DETAILS
Member #: Firstname: Address: Daytime ph: Email: ** Mobile Ph: Surname:

**MFC does not take responsibility for orders that do not reach us by the cut off date. Please fill in your email address to receive confirmation of your order. Confirmation will be sent after the booking cut off date.

TICKET ORDER Member Tickets

Reserved Seating Price Adult $38.00 Total tickets required & Member #s $ Amount

Concession

$30.00

Junior

$19.50

Non- Member Tickets

Reserved Seating Price Adult Concession Junior $41.00 $33.00 $22.50 Total tickets required $ $ $ Amount

PAYMENT
CHEQUE / MONEY ORDER / CREDIT CARD VISA / MASTERCARD (please circle)

Credit Card #: Cardholder Name: Signature:

__ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __

Exp:

__ __ /__ __

Amount

BOOKING CUT OFF DATE 5.00pm Thursday June 23, 2011

Contact MFC immediately if you do not receive email confirmation of your order after this date (NO LATE BOOKINGS WILL BE ACCEPTED)

Please mail form to:

Melbourne Football Club Membership Services PO BOX 204 MELBOURNE VIC 3001

Email to: membership@melbournefc.com.au Fax to: Fax to: (03) 9643 1766

Tickets will be mailed to you directly in the week prior to the match