Ticket Request Form

Print form then complete all information and submit by FAX TO: 704.455.8864

Promotions in Motion 5243 Morehead Road - Harrisburg, NC  Phone: 704.455.886

	Event: _______________________________________ Location: ____________________________

	Event Date: __________________________________ # of Tickets: __________________________

	Bill To: _________________________________Ship to: ___________________________________

	Street Address: __________________________________________________________________
		(Sorry, no P.O. Boxes)

	City, State, Zip: ___________________________________________________________________

	Daytime Phone: _________________________________ Fax: ____________________________

	Additional info: ___________________________________________________________________
	MasterCard or Visa card #: ________________________________ Expires: _____________

Thank you for your request.  Your ticket order will be processed  in the order that it is received. All orders will be charged $15 for Fedex shipping and handling fee.  A signature will be required for the package to be delivered.

Please Note: Tickets cannot be cancelled once ordered. Your signature allows your credit card to be charged the full price of the ticket order. I have read and understand the ticket order conditions. I am allowing my credit card to be charged for the full ticket order price

Authorized Signature: _____________________________________Date: _______________

Please fax your request to Promotions in Motion at 704-455-8864.