Please print name exactly as you would like it to appear in all printed materials: _______________________________________________________ Tickets: Tickets are

$55 per person for individual tickets.

Number of tickets: _______

If purchasing more than one ticket, please indicate additional guests/guests names here: ________________________________________________________________
You will also have the opportunity to provide guests names at a later date.

If you would like to support Mu Epsilon Theta by reserving or sponsoring a table of 10, please contact Felicia Ramos at anniversary@muepsilontheta.org for more information.

I would like to purchase a parking pass ($7, valid for on-site garage parking for one (1) vehicle)
Payment:

Enclosed is my check in the amount of $___________. Kindly make checks payable to Mu Epsilon Theta. Please charge my credit card: Ticket prices will include a $2 card processing fee per ticket.
American Express Visa MasterCard
Expiration Date:______________ Company: __________________ Card Number:__________________________ Name: __________________________________ Phone: _______________

Name on Card: _______________________________________________________ Address: _________________________________ City, State, Zip: ______________ E-mail:___________________________________

Please mail an invoice to the address above.

Please mail this form to: Rosa Marroquin, Attn: ME Anniversary 2010 University Avenue, Austin, TX 78705 Please e-mail anniversary@muepsilontheta.org after mailing your payment! Contact Felicia Ramos at (512) 553-3697 or anniversary@muepsilontheta.org with any questions. Full details about the Mu Epsilon Theta 25th Anniversary weekend can be found at www.muepsilontheta.org/anniversary