Ticket Reservation Form     

Use your computer to fill in form and then print form.            

Make checks payable to Jan Staats

Mail to: Jan Staats
6320 Faircrest Road
Columbus, Ohio 43229

Name:

Address:

City, State, Zip:

Phone:  

Number of [email protected] $12.00   Number of [email protected] $15.00   Total Amount

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