Purchase Tickets

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I WOULD LIKE TO PURCHASE:


_________ # Table(s) at $175 each table (six seats per table) = $__________


_________ # Seat(s) at $35 each seat = $ _____________ 

($50 after October 13, 2023)

_________ # Seat(s) at $50 each seat = $ _____________


Name/Business Name: ________________________________________________________


Contact Person: ______________________________________________________________


Address: ___________________________________________________________________


City: ___________________________________ State: ______________ Zip: _____________


Telephone Number: _______________________E-mail: _______________________________


Payment (MasterCard or Visa)

Card # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiration Date: _________________


Name on the Card: ___________________________________________________________


Signature: _______________________________________ Billing Zip Code: ______________


Make checks payable to: City of Ellisville


Mail to: City of Ellisville

1 Weis Avenue

Ellisville, MO 63011


Please reserve and pay by October 18, 2024

For additional information contact:
 Ada Hood at ahood@ellisville.mo.us