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Your 20010-11 HCCA Membership Application | Join us for our 65th Season!


Benefactor ** (6 memberships) $375 $ ________
Sponsor ** (4 memberships) $210 $ ________
Patron ** (2 memberships) $110 $ ________
Friend ** $60 each X ______ $ ________
Adult $40 each X ______ $ ________
Student $10 each X ______ $ ________
Family Patron ** $120 (2 adults + children living at home) $ ________
No. of children's tickets needed _____

Family $90 (2 adults + children living at home) $ ________
No. of children's tickets needed _____

** Name listed in program and invitation to "Meet the Artist" reception following a selected concert.
Name __________________________________________________
Address __________________________________________________
City/State/Zip _______________________________ ______ ____________
Telephone ( ______ ) ________________
Check Enclosed (Make check payable to "Hartsville-Coker Concert Association") OR
Charge my    Visa    MasterCard Expiration Date _______  

Card # _________________________________
Name on Card _____________________________ Signature ___________________________________

Please provide your e-mail address to receive concert reminders - including HCCA & Coker College
events and membership updates :

___________________________________



With your permission (by way of providing your e-mail address above), the HCCA
will e-mail you reminders and notices about HCCA and Coker College performing arts events.
This service will send an electronic reminder of upcoming concerts and notices to our members
and others interested parties.

Return this completed application, with your check or credit card information to:
Hartsville-Coker Concert Association, P.O.Box 2283, Hartsville, SC 29551-228