Tickets Reservation Form

Group Tickets	=	ordering 10 or more tickets will be discounted ............	$ 12 each.
Early Bird Tickets	=	orders made in October or November Only...................	$ 15 each.
December Tickets	=	orders made in December by phone or at the door.....	$ 25 each.

(816-619-3499)

Type	Price	Quantity	Total	Purchase Tom's Inspirational CD's Click Here
Group Tickets (10 or more)
December Individual Rate
Child Rate
	Grand Total		$ *

*Plus $1 for postage, processing & handling

Tickets for Tom’s Concert are available for purchase on
concert night, December 4th, in the lobby of Unity Temple,
beginning at 6pm......Ticket price at the door is $25 dollars.

Options for payment:

check

credit card

phone order

Checks:

Please print this order form and send with your check or money order to:
Tom Jacobs - 7801 E 325th Street - Drexel, MO 64742-2514

Credit Card:

For your safety, no credit card transactions are made on line. This form notifies us of your order. We'll call you for your credit card information.

Phone Order:

Call-in at 816-619-3499 (or long distance toll free): 1-888-463-7664

Personal data:

First Name:		Last Name:
Organization:		Address 1:
Address 2:		City:
State:		Zip Code:
Work Phone:		Home Phone:
E-mail

Specifically Interested In: Concerts Yoga Classes Retreats/Workshops Progress of Timber Creek Hearth House All Of The Above

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