Weekend Of The Pooka:  A Celebration Of The Arts
Ticket Order Form for Olympic Jazz Quintet Concert

Name _________________________________   Phone ________________________

Address ______________________________________________________________

City ____________________State______________________  Zip________________

Please send me:

Concert Only tickets: [     ]  @ $20 each

Concert  & Reception: [     ]  @ $35 each

Total amount enclosed $_________________

Make check payable to:  The City Of Bedford Arts & Culture Board

Deadline for purchase:  September 3, 2011

Mail check and order form to:

Bedford Arts & Culture Board
City of Bedford
165 Center Road
Bedford, OH 44146

Tickets will be sent to above address by return mail.