Please Print this form, and mail it to:

Ars Antiqua
26 North Greeley Ave.
Chappaqua, New York 10514

Quantity			Subtotal
_______	VIP Benefactor (Front Row Seating with Autographed Artist's CD's, Gift Bags & Pre-Concert Backstage Dinners with the Artists)	$1000	$_____________
_______	Benefactor (First Priority Seating)	$500	$_____________
_______	Donor (Second Priority Seating)	$250	$_____________
_______	Patron (Special Reserved Seats)	$175	$_____________
_______	Sponsor (General Admission)	$150	$_____________
_______	Single Ticket Subscription (General Admission)	$75	$_____________
		Total:	$_____________

Name:___________________________________________________________

Address:_________________________________________________________

City:_______________________________State__________Zip_____________

Phone:________________________________

Email:___________________________________________________________

Please make checks payable to: Ars Antiqua

Mail to the Ars Antiqua administrative office at:
26 North Greeley Avenue
Chappaqua, New York 10514

For information and ticket availability call (914) 238-8015