Advance Tickets Order Form

To order by mail, print this form, fill it out, and send to: Detroit Skating Club / 888 Denison Ct / Bloomfield Hills MI 48302 / attn: Georgia Hartsell. Make checks payable to "2000 Chevrolet Synchronized Team Championships". There is a $25 fee for returned checks. Advance prices valid on orders received by Feb 15, 2000.

Name:        ___________________________________________________________

Address:     ___________________________________________________________

City/ST/Zip: ___________________________________________________________

Phone:       (    ) ________________   Fax: (    ) _____________________

METHOD OF PAYMENT (circle one)    VISA   MasterCard   Check  MoneyOrder

Card Number: _______________________   Exp Date:   _____________________

Print Name:  ___________________________________________________________

Signature:   ___________________________________________________________