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DONORS:<br />
EXPRESS<br />
CHECKOUT:<br />
PAYMENT<br />
INFORMATION:<br />
QUEEN MARGARET’S SCHOOL<br />
660 Brownsey Avenue<br />
Duncan, British Columbia, Canada V9L 1C2<br />
T 250 746‐4185 | F 250 746‐4187 | www.qms.bc.ca<br />
QMS SPRING CLASSIC BARN DANCE & AUCTION<br />
ORDER YOUR TICKETS TODAY!<br />
(Please print all information)<br />
Name: _________________________________________________________________<br />
Address: ___________________________________ Postal Code: _________________<br />
Phone #: ______________________ Email: ___________________________________<br />
Please reserve _____________ tickets at $25.00 each.<br />
Please list the name of each guest as it should appear on the guest list<br />
_________________________ _________________________<br />
_________________________ _________________________<br />
_________________________ _________________________<br />
_________________________ _________________________<br />
□ I would like to make a donation of $__________ for a full tax receipt<br />
and donor recognition.<br />
□ I authorize Queen Margaret’s School to charge any purchases or expenses<br />
incurred in relation to the QMS Spring Classic Barn Dance & Auction on<br />
Saturday, May 11 th , 2013, to my credit card listed below.<br />
□ My cheque is enclosed for $___________ or charge my<br />
□ Visa<br />
□ MasterCard<br />
□ American Express<br />
Credit Card Number: _________________________ Expiry: ___________________________<br />
Print Name on Card: ____________________________________________________________<br />
A donation receipt will not be issued because of the reduced ticket price. If you have already called to<br />
reserve tickets, thank you for your support.<br />
Please return this form to Reception at Queen Margaret’s School or fax it to 250‐746‐4187.<br />
For more information – contact QMS Reception – Telephone 250‐746‐4185 or email barndance@qms.bc.ca.