First Name:   Last Name:

Address:

Tel: Fax:

Email:

Yes, I (we) plan to attend the Medical Musical Group's free concert on May 14, 2008
at the National Shrine. There will be    in my party.

We will need bus transportation from and to hotel
($20.00 per person for the round trip).

Method of Payment

Check. Please mail to: MMG, 1627 Preston Road, Alexandria, VA 22302

Credit Card. You will be given the option to pay via our Secure Pay Pal Site following
the the submission of this information form.

I wish to inquire about participating in the Medical Musical Chorus/Orchestra.
  My Voice Part is: My Musical Instrument is .
  My Level is:

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