RESERVED SEAT MAIL IN ORDER FORM

PRICE EACH - $17.00(1 year & up)

Buy tickets in person at: Circus office, 6613 Seybold Rd. suite A, Madison, WI. 53719

For more information call: 608-274-9884

Mail check with order form to: Shrine Circus

P O Box 44758

Madison, WI. 53744-4758

Your: Name _________________________________ phone ________________________

Address ______________________________________________________________

City ______________________________________, St _____ Zip code ____________