2011 Community Involvement Program DEADLINE TO PLACE ORDERS NOVEMBER 8, 2010 Tickets valid for one day one park only. Six tickets maximum per family Name of Guest:
Place an X in the appropriate box All tickets are shipped via Common Carrier/Signature Required
Ilan Goldman
Name of Organization:
Friendship Circle
Street Address for tickets (No PO Boxes will be accepted): 4433 Mistral Place
City:
San Diego
Zip Code:
Daytime telephone:
92130
(619) 200-5751
Email Address:
circlestretch@yahoo.com
Note: Please verify address. If your address is not correct, contact the organization that provided you this form. Email address is required, as all communicatons will be sent via this email address.
Tickets Qty
With Shipping
Selection
1
$ 41
1
2
$ 72
1
3
$103
1
4
$134
1
5
$165
6
$196
1
ORDER YOUR TICKETS ONLINE To order your tickets online and ensure you get your requested week, please follow the instruction below: Visit out website at http://publicaffairs.disneyland.com/CIP Have your Customer Code ready. Customer Code: F1E70FDF The website will verify your identity by asking your 5 digit Zip Code Payment can be made either by check, money order, or cashiers check (If check does not clear on first try, check and original order will be returned to guest. No new order will be accepted for guest unless money order or cashier’s check is sent back in with additional $35.00 service charge. No new personal check will be accepted. Same receipt dates for new payment apply.) See website for additional details
Indicate your week choices by numbering the weeks below 1-5 in order of your preference. If you are unavailable for a particular week, leave that space blank If no week is selected, your order will be returned to you unprocessed.
____
Sunday - Thursday
Jan 9th - 13th
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Tuesday - Saturday
Jan 18th - 22nd
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Sunday - Saturday
Jan 23rd - 29th
____
Sunday - Saturday
Jan 30th - Feb 5th
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Sunday - Saturday
Feb 6th - 12th
WHEN MAILING THIS ORDER FORM, PLEASE CONFIRM THE FOLLOWING: Order form must be received (not Postmarked) by DMM on or before November 8, 2010 This order form is an original, COPIES NOT ACCEPTED. Only one order per unique barcode. A check, money order or cashier’s check made payable to DELUXE is included
Customer Code
Payment is for the correct amount using the above payment grid
DMM – Community Involvement Program P.O. Box 917 Santa Clarita, CA 91380-9910
This ticket offer is NOT VALID for purchase at Disneyland® Resort Ticket booths