SDEMS

 

 

 

 

 

 

 

 

Please print out this form and mail to:

San Diego Early Music Society
PO Box 82008
San Diego, CA 92138

Hold the longest note you can in this time of cutback to the arts...

___ FUSA (Students) $20
___ FUSA (Single) $25
___ FUSA (Household) $35
___ SEMIMINIMA $50 - $99
___ MINIMA $100 - $249 *
___ SEMIBREVIS $250 - $499 **
___ BREVIS $500 - $999 ***
___ LONGA $1000 - $2499 #
___ MAXIMA $2500 - $4999 ##
___ DOUBLE MAXIMA $5000 amd up ###

_____________________________________________________________
 

*   1 SDEMS bonus ticket
**   2 SDEMS bonus tickets, CD
***   3 SDEMS bonus tickets, CD
#   4 SDEMS bonus tickets, CD
##   5 SDEMS bonus tickets, CD
###   6 SDEMS bonus tickets, CD


Total amount: $______________
Payment method: ___ Visa     ___ MasterCard     ___ Check or Money Order (enclosed)
Credit card number: ____________________________________  Exp. date: __________
Cardholder’s name: ______________________________________
Signature: ______________________________________
Name: ______________________________________
E-mail address: ______________________________________
Telephone: ______________________________________
Street address: ______________________________________
Street address (line 2): ______________________________________
City: ______________________________________
State/province: ______________________________________
Zip/postal code: ______________________________________
Country: ______________________________________


___ Please do not list my name in the directory or concert programs.

I play the following early musical instrument(s): _______________________________


I sing:     ___ soprano ___ alto ___ tenor ___ bass