CUSTOMER ACCOUNT NUMBER (OFFICE USE ONLY) _______________________________________________________________________________ NAME _______________________________________________________________________________ ADDRESS _______________________________________________________________________________ CITY STATE ZIP CODE _______________________________________________________________________________ DAY PHONE EVENING PHONE _______________________________________________________________________________ EMAIL ADDRESS Please make checks out to EMBASSY THEATRE check #________________________________ Please charge the full amount to my: n Visa n MasterCard n Amex n Discover _______________________________________________________________________________ CARD NUMBER EXP. DATE _______________________________________________________________________________ NAME ON CARD X _______________________________________________________________________________ SIGNATURE Subscription package price includes all taxes, fees and service charges. Prices, shows, schedules and artists subject to change. Payments processed when orders are received. All sales are final, no refunds. Season tickets will be mailed prior to first performance. PAYMENT INFORMATION TOTAL YOUR ORDER Handling Charge + $6.00 TOTAL = SUBSCRIBING IS EASY! ONLINE: CALL: The Embassy Box Office 125 W. Jefferson Blvd. Ft. Wayne, IN 46802 FWEmbassyTheatre.org 260.424.5665 MAIL: SELECT YOUR SERIES AND PRICE LEVEL LEVEL 1 LEVEL 2 LEVEL 3 x $ = $ # of Seats Price Subtotal n 4 Shows 4 - Show Series n $295.00 n $215.00 n $150.00 LEVEL 1 LEVEL 2 LEVEL 3 STAGE Fiddler On The Roof Wednesday, February 5, 2020 7:30pm Beautiful Wednesday, April 15, 2020 7:30pm Waitress Tuesday, April 21, 2020 7:30pm Cats Tuesday, May 5, 2020 7:30pm SUBSCRIBE TODAY FWEmbassyTheatre.org CALL 260.424.5665 BROADWAY AT THE EMBASSY presents MUSIC BY 7-TIME GRAMMY NOMINEE SARA BAREILLES ORIGINALLY PRODUCED BY CAMERON MACKINTOSH AND THE REALLY USEFUL GROUP LIMITED TM © 1981 RUG LTD LET THE MEMORY LIVE AGAIN