<h2>Ticket Order Form</h2>
<p>You can now reserve your tickets ONLINE in three easy steps. If you have any questions, e-mail <a href="mailto:gandree@siue.edu">gandree@siue.edu</a> or contact the Fine Arts Box Office in Dunham Hall at (618) 650-2774.</p>
<p><strong>Step 1:</strong> Select the ticket(s) you would like to reserve below. Click the “Calculate” button to confirm the total. <strong>Note: a $2 service and handling fee applies to online orders.</strong></p>
<form name="mail" action="http://www.siue.edu/cgi-bin/FormMail.pl" method="post">
<input name="recipient" type="hidden" value="gandree@siue.edu" /><input name="required" type="hidden" value="email" /><input name="redirect" type="hidden" value="http://www.siue.edu/artsandissues/thanks.shtml" /><input name="subject" type="hidden" value="Arts and Issues Series Ticket Order" />
<table border="0" width="100%" cellpadding="3" cellspacing="0">
<tr>
<td width="18%"></td>
<td bgcolor="#000000" width="14%">
<div align="center"><span style="color:#FFFFFF;"><strong># of subscriptions</strong></span></div>
</td>
<td bgcolor="#000000" width="15%">
<div align="center"><span style="color:#FFFFFF;"><strong># of subscriptions</strong></span></div>
</td>
<td bgcolor="#000000" width="13%">
<div align="center"><span style="color:#FFFFFF;"><strong>Alumni Single</strong></span></div>
</td>
<td bgcolor="#000000" width="13%">
<div align="center"><span style="color:#FFFFFF;"><strong>General Single</strong></span></div>
</td>
<td bgcolor="#000000" width="11%">
<div align="center"><span style="color:#FFFFFF;"><strong>Students</strong></span></div>
</td>
<td bgcolor="#000000" width="3%">
<div align="center"></div>
</td>
<td bgcolor="#000000" width="13%">
<div align="center"><span style="color:#FFFFFF;"><strong>Total</strong></span></div>
</td>
</tr>
<tr>
<td></td>
<td bgcolor="#000000">
<div align="center"><span style="color:#FFFFFF;"><strong>all 7 shows</strong></span></div>
</td>
<td bgcolor="#000000">
<div align="center"><span style="color:#FFFFFF;"><strong>pick 5-6 shows</strong></span></div>
</td>
<td bgcolor="#000000">
<div align="center"><span style="color:#FFFFFF;"><strong>Ticket</strong></span></div>
</td>
<td bgcolor="#000000">
<div align="center"><span style="color:#FFFFFF;"><strong>Ticket</strong></span></div>
</td>
<td></td>
<td>
<div align="center"></div>
</td>
<td></td>
</tr>
<tr>
<td bgcolor="#cccccc"><strong>Theodore Sorensen</strong><br /> October 9, 2008</td>
<td bgcolor="#cccccc"></td>
<td bgcolor="#cccccc"><input name="number_of_pick5-6_theodore_sorenson_tickets" size="3" type="text" value="" id="number_of_pick5-6_theodore_sorenson_tickets" /><label for="number_of_pick5-6_theodore_sorenson_tickets">x</label> $23</td>
<td bgcolor="#cccccc"><input name="number_of_alumni_theodore_sorenson_tickets" size="3" type="text" value="" id="number_of_alumni_theodore_sorenson_tickets" /><label for="number_of_alumni_theodore_sorenson_tickets">x</label> $25</td>
<td bgcolor="#cccccc"><input name="number_of_general_theodore_sorenson_tickets" size="3" type="text" value="" id="number_of_general_theodore_sorenson_tickets" /><label for="number_of_general_theodore_sorenson_tickets">x</label> $27</td>
<td bgcolor="#cccccc"><input name="number_of_student_theodore_sorenson_tickets" size="3" type="text" value="" id="number_of_student_theodore_sorenson_tickets" /><label for="number_of_student_theodore_sorenson_tickets">x</label> $12</td>
<td bgcolor="#cccccc">
<div align="center">=</div>
</td>
<td bgcolor="#cccccc">$ <input name="theodore_sorenson_total_cost" size="10" type="text" value="" id="theodore_sorenson_total_cost" /></td>
</tr>
<tr>
<td><strong>Savion Glover</strong><br /> October 30, 2008</td>
<td></td>
<td bgcolor="#ffffff"><input name="number_of_pick5-6_savion_glover_tickets" size="3" type="text" value="" id="number_of_pick5-6_savion_glover_tickets" /><label for="number_of_pick5-6_savion_glover_tickets">x</label> $23</td>
<td bgcolor="#ffffff"><input name="number_of_alumni_savion_glover_tickets" size="3" type="text" value="" id="number_of_alumni_savion_glover_tickets" /><label for="number_of_alumni_savion_glover_tickets">x</label> $25</td>
<td bgcolor="#ffffff"><input name="number_of_general_savion_glover_tickets" size="3" type="text" value="" id="number_of_general_savion_glover_tickets" /><label for="number_of_general_savion_glover_tickets">x</label> $27*</td>
<td bgcolor="#ffffff"><input name="number_of_student_savion_glover_tickets" size="3" type="text" value="" id="number_of_student_savion_glover_tickets" /><label for="number_of_student_savion_glover_tickets">x</label> $12</td>
<td>
<div align="center">=</div>
</td>
<td>$ <input name="savion_glover_tickets_total_cost" size="10" type="text" value="" id="savion_glover_tickets_total_cost" /></td>
</tr>
<tr>
<td bgcolor="#cccccc"><strong>Boys of the Lough</strong><br /> December 10, 2008</td>
<td bgcolor="#cccccc"></td>
<td bgcolor="#cccccc"><input name="number_of_pick5-6_boys_of_the_lough_tickets" size="3" type="text" value="" id="number_of_pick5-6_boys_of_the_lough_tickets" /><label for="number_of_pick5-6_boys_of_the_lough_tickets">x</label> $23</td>
<td bgcolor="#cccccc"><input name="number_of_alumni_boys_of_the_lough_tickets" size="3" type="text" value="" id="number_of_alumni_boys_of_the_lough_tickets" /><label for="number_of_alumni_boys_of_the_lough_tickets">x</label> $25</td>
<td bgcolor="#cccccc"><input name="number_of_general_boys_of_the_lough_tickets" size="3" type="text" value="" id="number_of_general_boys_of_the_lough_tickets" /><label for="number_of_general_boys_of_the_lough_tickets">x</label> $27</td>
<td bgcolor="#cccccc"><input name="number_of_student_boys_of_the_lough_tickets" size="3" type="text" value="" id="number_of_student_boys_of_the_lough_tickets" /><label for="number_of_student_boys_of_the_lough_tickets">x</label> $12</td>
<td bgcolor="#cccccc">
<div align="center">=</div>
</td>
<td bgcolor="#cccccc">$ <input name="boys_of_the_lough_tickets_total_cost" size="10" type="text" value="" id="boys_of_the_lough_tickets_total_cost" /></td>
</tr>
<tr>
<td><strong>Doris Kearns Goodwin</strong><br /> February 5, 2009</td>
<td></td>
<td bgcolor="#ffffff"><input name="number_of_pick5-6_doris_kearns_goodwin_tickets" size="3" type="text" value="" id="number_of_pick5-6_doris_kearns_goodwin_tickets" /><label for="number_of_pick5-6_doris_kearns_goodwin_tickets">x</label> $23</td>
<td bgcolor="#ffffff"><input name="number_of_alumni_doris_kearns_goodwin_tickets" size="3" type="text" value="" id="number_of_alumni_doris_kearns_goodwin_tickets" /><label for="number_of_alumni_doris_kearns_goodwin_tickets">x</label> $25</td>
<td bgcolor="#ffffff"><input name="number_of_general_doris_kearns_goodwin_tickets" size="3" type="text" value="" id="number_of_general_doris_kearns_goodwin_tickets" /><label for="number_of_general_doris_kearns_goodwin_tickets">x</label> $27</td>
<td bgcolor="#ffffff"><input name="number_of_student_doris_kearns_goodwin_tickets" size="3" type="text" value="" id="number_of_student_doris_kearns_goodwin_tickets" /><label for="number_of_student_doris_kearns_goodwin_tickets">x</label> $12</td>
<td>
<div align="center">=</div>
</td>
<td>$ <input name="doris_kearns_goodwin_tickets_total_cost" size="10" type="text" value="" id="doris_kearns_goodwin_tickets_total_cost" /></td>
</tr>
<tr>
<td bgcolor="#cccccc"><strong>First Person</strong><br /> February 20, 2009</td>
<td bgcolor="#cccccc"></td>
<td bgcolor="#cccccc"><input name="number_of_pick5-6_first_person_tickets" size="3" type="text" value="" id="number_of_pick5-6_first_person_tickets" /><label for="number_of_pick5-6_first_person_tickets">x</label> $23</td>
<td bgcolor="#cccccc"><input name="number_of_alumni_first_person_tickets" size="3" type="text" value="" id="number_of_alumni_first_person_tickets" /><label for="number_of_alumni_first_person_tickets">x</label> $25</td>
<td bgcolor="#cccccc"><input name="number_of_general_first_person_tickets" size="3" type="text" value="" id="number_of_general_first_person_tickets" /><label for="number_of_general_first_person_tickets">x</label> $27</td>
<td bgcolor="#cccccc"><input name="number_of_student_first_person_tickets" size="3" type="text" value="" id="number_of_student_first_person_tickets" /><label for="number_of_student_first_person_tickets">x</label> $12</td>
<td bgcolor="#cccccc">
<div align="center">=</div>
</td>
<td bgcolor="#cccccc">$ <input name="first_person_tickets_total_cost" size="10" type="text" value="" id="first_person_tickets_total_cost" /></td>
</tr>
<tr>
<td><strong>Beyond Abby Road</strong><br /> March 20, 2009</td>
<td></td>
<td bgcolor="#ffffff"><input name="number_of_pick5-6_beyond_abby_rd_tickets" size="3" type="text" value="" id="number_of_pick5-6_beyond_abby_rd_tickets" /><label for="number_of_pick5-6_beyond_abby_rd_tickets">x</label> $23</td>
<td bgcolor="#ffffff"><input name="number_of_alumni_beyond_abby_rd_tickets" size="3" type="text" value="" id="number_of_alumni_beyond_abby_rd_tickets" /><label for="number_of_alumni_beyond_abby_rd_tickets">x</label> $25</td>
<td bgcolor="#ffffff"><input name="number_of_general_beyond_abby_rd_tickets" size="3" type="text" value="" id="number_of_general_beyond_abby_rd_tickets" /><label for="number_of_general_beyond_abby_rd_tickets">x</label> $27**</td>
<td bgcolor="#ffffff"><input name="number_of_student_beyond_abby_rd_tickets" size="3" type="text" value="" id="number_of_student_beyond_abby_rd_tickets" /><label for="number_of_student_beyond_abby_rd_tickets">x</label> $12</td>
<td>
<div align="center">=</div>
</td>
<td>$ <input name="beyond_abby_rd_tickets_total_cost" size="10" type="text" value="" id="beyond_abby_rd_tickets_total_cost" /></td>
</tr>
<tr>
<td bgcolor="#cccccc"><strong>T.S. Monk</strong><br /> April 25, 2009</td>
<td bgcolor="#cccccc"></td>
<td bgcolor="#cccccc"><input name="number_of_pick5-6_ts_monk_tickets" size="3" type="text" value="" id="number_of_pick5-6_ts_monk_tickets" /><label for="number_of_pick5-6_ts_monk_tickets">x</label> $23</td>
<td bgcolor="#cccccc"><input name="number_of_alumni_ts_monk_tickets" size="3" type="text" value="" id="number_of_alumni_ts_monk_tickets" /><label for="number_of_alumni_ts_monk_tickets">x</label> $25</td>
<td bgcolor="#cccccc"><input name="number_of_general_ts_monk_tickets" size="3" type="text" value="" id="number_of_general_ts_monk_tickets" /><label for="number_of_general_ts_monk_tickets">x</label> $27</td>
<td bgcolor="#cccccc"><input name="number_of_student_ts_monk_tickets" size="3" type="text" value="" id="number_of_student_ts_monk_tickets" /><label for="number_of_student_ts_monk_tickets">x</label> $12</td>
<td bgcolor="#cccccc">
<div align="center">=</div>
</td>
<td bgcolor="#cccccc">$ <input name="ts_monk_tickets_total_cost" size="10" type="text" value="" id="ts_monk_tickets_total_cost" /></td>
</tr>
<tr>
<td><strong>Subscription x7 events</strong></td>
<td><input name="number_of_x7_events_tickets" size="3" type="text" value="" id="number_of_x7_events_tickets" />x $147<br /> ($21 per ticket)</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>
<div align="center">=</div>
</td>
<td>$ <input name="x7_events_tickets_total_cost" size="10" type="text" value="" id="x7_events_tickets_total_cost" /></td>
</tr>
<tr>
<td colspan="7"></td>
<td></td>
</tr>
<tr>
<td colspan="7">
<div align="right">Subtotal</div>
</td>
<td>$ <input name="subtotal" size="10" type="text" value="" id="subtotal" /></td>
</tr>
<tr>
<td colspan="7">
<div align="right">Service fee of $2.00 for charge card orders only</div>
</td>
<td>$ <input name="service_fee" size="10" type="text" value="2" id="service_fee" /></td>
</tr>
<tr>
<td colspan="7">
<div align="right">My Contribution to Arts & Issues</div>
</td>
<td>$ <input name="contribution" size="10" type="text" value="0" id="contribution" /></td>
</tr>
<tr>
<td bgcolor="#cccccc" colspan="7">
<div align="right">Total Ticket Order</div>
</td>
<td bgcolor="#cccccc">$ <input name="total" size="10" type="text" id="total" /></td>
</tr>
<tr>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>
<div align="center"><input onclick="calculate()" type="button" value="Calculate" /></div>
</td>
</tr>
</table>
<br />
<table border="0" width="500" cellspacing="0" cellpadding="5">
<tr>
<td width="107">Name:</td>
<td><input name="realname" size="30" type="text" value="Full Name" onfocus="this.value=''" id="realname" /></td>
</tr>
<tr>
<td>Address:</td>
<td><input name="address" size="30" type="text" value="Address" onfocus="this.value=''" id="address" /></td>
</tr>
<tr>
<td>City:</td>
<td><input name="city" size="30" type="text" value="City" onfocus="this.value=''" id="city" /></td>
</tr>
<tr>
<td>State:</td>
<td><input name="state" size="8" type="text" value="State" onfocus="this.value=''" id="state" /></td>
</tr>
<tr>
<td>Zip:</td>
<td><input name="zip" size="8" type="text" value="Zip Code" onfocus="this.value=''" id="zip" /></td>
</tr>
<tr>
<td>Daytime Phone:</td>
<td><input name="phone" size="20" type="text" value="Phone Number" onfocus="this.value=''" id="phone" /></td>
</tr>
<tr>
<td>e-mail:</td>
<td><input name="email" size="20" type="text" value="E-mail Address" onfocus="this.value=''" id="email" /></td>
</tr>
<tr>
<td></td>
<td></td>
</tr>
<tr>
<td></td>
<td><strong>Where did you learn of this events at SIUE?</strong></td>
</tr>
<tr>
<td></td>
<td><input name="how_did_you_hear_about_us" type="radio" value="radio" id="radio" />Radio</td>
</tr>
<tr>
<td></td>
<td><input name="how_did_you_hear_about_us" type="radio" value="newspaper" id="newspaper" />Newspaper</td>
</tr>
<tr>
<td></td>
<td><input name="how_did_you_hear_about_us" type="radio" value="mailing" id="mailing" />Mailing</td>
</tr>
<tr>
<td></td>
<td><input name="how_did_you_hear_about_us" type="radio" value="other" />Other: <input name="other" size="25" type="text" value="" onfocus="this.value=''" /></td>
</tr>
<tr>
<td></td>
<td></td>
</tr>
<tr>
<td></td>
<td><strong>Select how you would like to pay for your tickets:</strong></td>
</tr>
<tr>
<td></td>
<td><input name="payment_type" type="radio" value="check" id="check" />Check</td>
</tr>
<tr>
<td></td>
<td><input name="payment_type" type="radio" value="mastercard" id="mastercard" />Mastercard</td>
</tr>
<tr>
<td></td>
<td><input name="payment_type" type="radio" value="visa" id="visa" />Visa</td>
</tr>
<tr>
<td></td>
<td><input name="payment_type" type="radio" value="discover" id="discover" />Discover</td>
</tr>
<tr>
<td></td>
<td><input name="payment_type" type="radio" value="american_express" id="american_express" />American Express</td>
</tr>
<tr>
<td></td>
<td></td>
</tr>
<tr>
<td></td>
<td>We will contact you to take your credit card information.<br /> If you are paying by check:<br /> Make it payable to the SIUE Foundation and mail to:<br /> Arts & Issues<br /> SIUE Box 1777<br /> Edwardsville, IL 62026-1608</td>
</tr>
<tr>
<td></td>
<td><input type="submit" value="Submit" /></td>
</tr>
</table>
</form>