Support the Symphony!

YES! I want to support great music and play a part in

the continued success of the Loudoun Symphony!

 Podium Club $2,500 and above

 Principal Chair Underwriter $1,500

 Conductor's Circle $1,000

 Patron $500-999

 Benefactor $250-499

 Supporter $100-249

 Member $50-99

Please print contributor’s name as it should appear in concert

playbill: _____________________________________

Donation Total = $_______

Season Tickets (4 concerts)

Adult ____ @ $55   = $ ______

Senior (65+) ____ @ $45   = $ ______

Youth (18 and under) ____ @ Free  = $ _____0

Symphony Spook-tacular

Saturday, October 27, 2007, 8 PM,

Sunday, October 28, 2007, 3 PM,

Adult ____ @ $15   = $ ______

Senior (65+) ____ @ $12   = $ ______

Youth (18 and under) ____ @ Free  = $ _____0

Holiday Pops

Saturday, December 15, 2007, 8 PM,

Sunday, December 16, 2007, 3 PM,

Adult ____ @ $15   = $ ______

Senior (65+) ____ @ $12   = $ ______

Youth (18 and under) ____ @ Free  = $ _____0

Timeless Journeys

Saturday, March 8, 2008, 8 PM,

Sunday, March 9, 2008, 3 PM,

Adult ____ @ $15   = $ ______

Senior (65+) ____ @ $12   = $ ______

Youth (18 and under) ____ @ Free  = $ _____0

Salsa to Salzburg

Saturday, May 17, 2008, 8 PM,

Sunday, May 18, 2008, 3 PM,

Adult ____ @ $15   = $ ______

Senior (65+) ____ @ $12   = $ ______

Youth (18 and under) ____ @ Free  = $ _____0

Ticket Order Total = $_______

10% discount for 10 or more tickets =$_______

TOTAL (Donation+Tickets-Discount) = $_______

Name ____________________________________________

Address __________________________________________

City/State/Zip ______________________________________

Day phone/evening phone ____________________________

E-mail ____________________________________________

       __ Previous Purchaser       __New Purchaser

PAYMENT OPTIONS

 Check enclosed payable to Loudoun Symphony

 VISA             Mastercard            Discover

Credit card number

_____________________________    ________   ___/___

Cardholder                                                       Billing Zip      Exp Dt

________________________________   ______________

Signature                                                             Date

 Interested in volunteer opportunities.

How did you hear about the Loudoun Symphony?

 Newspaper: ________________________________

 Radio: ____________________________________

 Poster

 Received Mailer/Postcard

 Friend

 Past season ticket holder

 Internet

 Other: ____________________________________

TICKET POLICY

All concertgoers must have a ticket. Ticket sales are final and no refunds are given. In the event the Symphony must cancel a concert, ticket purchasers may opt to receive a ticket voucher for a future concert or a receipt for a tax-deductible donation in the amount of the original ticket purchase. Subscribers and ticket purchasers may request a receipt for a tax-deductible donation in the amount of their ticket purchase if tickets are returned to the Symphony office at least 48 hours (two days) prior to a scheduled concert date.

For office use:

Approval #: ________________ Process Date:____________

Order taken by: _____________  Date: __________________