2016/17 Season Backstage Tour Dates
Tours of the Civic Opera House for students in grades 3 to 12
School name: Contact name: Title/subject area: Contact email (required): School Address: City:
State:
Daytime phone:
Contact cell phone (required):
2016/17 Season Backstage Tour Dates October 24 January 26 November 18 February 24, 28 December 1, 7 March 6, 8, 14, 17, 20, 22
Zip code:
Choose up to three possible dates in order of preference:
1) 2) 3)
Earliest possible arrival time: Latest possible departure time: Do any of your students have accessibility needs? Yes No If so, please list accommodations needed: Grade level(s) # of Students # of Chaperones Total
X $6.00
=$
TOTAL DUE
Payment in full must accompany all orders. No exchanges or refunds—even in the event of inclement weather or school closings.
PAYMENT OPTIONS:
Pay by Purchase Order
PO#:
Check (payable to Lyric Opera of Chicago) Credit card (Visa, Mastercard, American Express, Discover)
Credit card number: Expiration date: Name on credit card: Signature:
Mail Form + Payment to: Lyric Opera of Chicago Lyric Unlimited 20 N. Wacker Dr., Suite 860 Chicago, IL 60606 Attn: Student Backstage Tours Or Charge by Fax: 312-419-1977
School name: Contact name: Title/subject area: Contact email (required): School Address: City:
State:
Daytime phone:
Contact cell phone (required):
2016/17 Season Backstage Tour Dates October 24 January 26 November 18 February 24, 28 December 1, 7 March 6, 8, 14, 17, 20, 22
Zip code:
Choose up to three possible dates in order of preference:
1) 2) 3)
Earliest possible arrival time: Latest possible departure time: Do any of your students have accessibility needs? Yes No If so, please list accommodations needed: Grade level(s) # of Students # of Chaperones Total
X $6.00
=$
TOTAL DUE
Payment in full must accompany all orders. No exchanges or refunds—even in the event of inclement weather or school closings.
PAYMENT OPTIONS:
Pay by Purchase Order
PO#:
Check (payable to Lyric Opera of Chicago) Credit card (Visa, Mastercard, American Express, Discover)
Credit card number: Expiration date: Name on credit card: Signature:
Mail Form + Payment to: Lyric Opera of Chicago Lyric Unlimited 20 N. Wacker Dr., Suite 860 Chicago, IL 60606 Attn: Student Backstage Tours Or Charge by Fax: 312-419-1977
