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Or send by mail to: S.I.M.S.C., Inc. P.O. Box 1064 Gualala, CA 95445 |
Call for more information: Local: (707) 884-4343 or (707) 884-9441 |
| Personal Information (Please print clearly) | |||
|---|---|---|---|
| Name: | |||
| Billing Address: | |||
| Street Address: | |||
| City: | |||
| State: | Zip Code: | ||
| Daytime Phone: | |||
| Fax: | |||
| Email: | |||
| Credit Card Type: | MasterCard Visa | ||
| Credit Card #: | Expiration: | ||
| Signature: | |||
| Delivery Information |
|---|
| Please MAIL my tickets to the above address |
| I would like to PICK-UP my tickets at the Sea Ranch Lodge |
| I would like to PICK-UP my tickets at the Gualala Country Inn in Gualala |
| Tickets Requested | Number | Amount |
|---|---|---|
| Tour & Tasting @ $40/person: | $ | |
| Optional Donation: | ------ | $ |
| Total: | $ | |