

| MAIL
TO: FLORIDA POWER CLUB P.O. BOX 13356 (EC37) ST. PETERSBURG, FL 33733 ATTN: Pat Corbissero EC37 |
Event
Coordinator: Pat Corbissero @ EC37 (727)384-7820 (Int.) 220-4820 |
NAME: _______________ MAC: ____ EXT/PHONE #:_____ e-mail and/or mailing address:____________________ Number of Adult Member Tickets: _____ @ $48.00; Number of Child (ages 3-9) Member Tickets: _____ @ $39.01 Number of Non-Member Adult Tickets _____ @ $67.10; Number of Child Non-Member Tickets: _____ @ $55.38 Total Dollar Amount enclosed: $________; Check #_______ |
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