UT HEALTH NORTHEAST STAFF ORDER FORM 2013-14 Order by phone

Dr. Carl Wieman Thursday, September 5

Charles Krauthammer Tuesday, February 4

Post-Lecture Receptions: one after each lecture event

DISTINGUISHED LECTURE SERIES 2-Lecture package as low as $30!

You must be 21 to attend lecture receptions. Reception tickets are $25 each.

Cirque Éloize Cirkopolis Thursday, September 12

The Ahn Trio & Nai-Ni Chen Dance Company Thursday, November 14

Dance Theatre of Harlem Thursday, January 23

Godspell Monday, March 3

Memphis Thursday, November 21Million Dollar Quartet Thursday, February 13The Addams Family Friday, April 4

Deer Camp: The Musical Tuesday, October 29

The Official Blues Brothers Revue Thursday, February 20

Jim Belushi & The Chicago Board of Comedy Friday, April 11

Circle Price Below For Each Series You Wish To Purchase D

PRICE2nd Orch

Rows JJ-NN

EPRICE

1st BalconyA-G

FPRICE

2nd BalconyRows AA-FF

APRICE1st Orch

Rows A-K

BPRICE1st Orch

Rows L-BB

CPRICE2nd Orch

Rows CC-HH

TicketQuantity

TicketTotal

$216 $195 $174 $144 $127 $85

DPRICE

EPRICE

FPRICE

APRICE

BPRICE

CPRICE

TicketQuantity

TicketTotal

$172 $159 $146 $134 $125 $87

PERFORMING ARTS SERIES 4-Show package as low as $85!

BROADWAY SERIES 3-Show package as low as $87!

BRAITHWAITE INTIMATE GATHERINGS SERIES 3-Show package as low as $57!

JOIN THE COWAN CENTER CIRCLE

YES! I would like to join the Cowan Thanks! I have already joined. Center Circle at the level circled at right.

+ $8.00

TOTAL =

Circle &Ticket Subtotal =

VALET = # shows __ X $10 =

For 4-6 payments add $2 =

Handling Fee (per order, not per ticket) =

+ $2.00Postage Fee

(all orders) =

DPRICE

EPRICE

FPRICE

APRICE

BPRICE

CPRICE

TicketQuantity

TicketTotal

$125 $100 $78$146

NAME

ADDRESS

CITY ST ZIP

EVENING PH DAY PH FAX

EMAIL (please print)

Check #___________________ enclosed made payable to UT Tyler

Please charge my: VISA MasterCard Discover AmEx

Signature

Card # Exp / CVC #

PAYMENT INFORMATION

By signing below, I agree to charges on my card for all indicated payments as indicated at right.

Order by phone 903-566-7424 UT HEALTH NORTHEAST STAFF ORDER FORM 2013-14

CUSTOMER INFORMATION

2 DISCOUNTS PER EVENTALL OTHERS REGULAR PRICEAll dates/programs subject to change. NO REFUNDS. NO EXCHANGES.All season tickets will be mailed in September. Each season ticket listed above includes $2/ticket for facility improvements.

SUPPORTINGROLE ACTORSTAR

EXECUTIVEPRODUCER PRODUCER

STAGEMANAGER CHORUS

MembershipTotal

$50$1000 $500$5000or more $200 $100

DIRECTOR

$2500$5000or more

SPECIAL EVENTS Only subscribers above may add special events at this time. (Seating will NOT be the same as subscription seats)

Menopause The Musical Thursday, September 26

Beyond Glory (Special ticket prices available for Veterans. Call for information.) Monday, November 4

EPRICE

FPRICE

DPRICE

APRICE

BPRICE

CPRICE

TicketQuantity

TicketTotal

$47 $42 $42$47 $37 $27

$42 $37 $32$42 $27 $22

EPRICE

FPRICE

DPRICE

APRICE

BPRICE

CPRICE

TicketQuantity

TicketTotal

$38 $30 $40$47 $31 $31N/A for subscriptions

$50 $50 $50$50 $50 $50N/A for subscriptions

Office Use Only

PAS

BWY

BIG

MTM

BG

LEC

CIRCLE

PAY 1

PAY 2

PAY 3

PAY 4

PAY5

PAY 6

PAYMENT PLAN OPTIONS

(Choose One)Payment plans not accepted

after July 30, 2013

See reverse for exact dates.

FILL

OUT

BOTH

SIDES

OF

ORDER

FORM

$70 $57N/A for subscriptions