REQUESTS: Reservation Requests will be accepted beginning Monday, August 30, 2010 on a first-come, first-served basis. Please fill out the information below to make your request.

CONTACT INFORMATION
Contact Name *
School *
Grade(s) *
Email *
Street
City/State	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip
Phone *	( ) -
Fax	( ) -
PERFORMANCE
FIRST PERFORMANCE CHOICE:
Performance Title *
Performance Time *	First Choice
If more than one performance time is available.
Performance Time	Second Choice
SECOND PERFORMANCE CHOICE:
Performance Title
Performance Time	First Choice
If more than one performance time is available.
Performance Time	Second Choice
If possible, I would like to reserve both performance choices
SEATING
Number of Students *	(Please note that you must pay for the original number of seats reserved. This number may not be reduced.)
Number of School Employees *
Number of Chaperones *
Wheelchairs?	Yes No        (If Yes, How many? )
PAYMENT POLICY
The deadline for payment is five working days before the performance. (Please note that you must pay for the original number of seats reserved. This number may not be reduced.) Checks must be made out to “Southeastern Louisiana University.” Cash is not accepted. Payments may not be split. Schools in Tangipahoa Parish must pay in person. Other parishes may mail payments, but they must arrive in time to send wristbands to the school.
CANCELLATION POLICY
Cancellations are not accepted. Full payment for the original number of seats reserved is expected.
WRISTBAND POLICY
Upon payment, wristbands will be issued for the total number of seats reserved. Each person (students and adults) must wear a wristband to be allowed entry into the Columbia Theatre’s Hainkel Hall. This policy will be strictly enforced. NO EXCEPTIONS.
I have read and agree to the Columbia Theatre’s Education Outreach policies.*
	All fields marked with * are required.