For your convenience, tickets may be used in either Hudson or Westborough.

Please print this form. Then enter the number of tickets you want for each concert and pricing category, and calculate the total, below:

Concert	General	Senior	Student (under 18)
1	#____ x $18	#____ x $16	#____ x Free
2	#____ x $18	#____ x $16	#____ x Free
3	#____ x $18	#____ x $16	#____ x Free
4	#____ x $18	#____ x $16	#____ x Free
Subscription to all 4 concerts	#____ x $68	#____ x $56	#____ x Free

Ticket Total $______

I would like to make a tax-deductable contribution to Symphony Pro Musica. (Include employer's Matching Gift Form, if applicable.)

$______

Total Enclosed $______

Please make checks payable to Symphony Pro Musica or select a credit card:

MasterCard	Visa
American Express	Discover

Number_________________________ Exp. date _____

Signature________________________________________

Mail or fax this form to:

Symphony Pro Musica PO Box 332 Hudson, MA 01749-0332 fax (978) 562-0322

Name (please print)___________________________

Street________________________________________

Town____________________ State_____ Zip_________

Phone___________________ Fax___________________

Email________________________________________