Registration for "Images" Series of Lectures

Please print this form, complete it, enclose a cheque or money order made out to "Canadian Friends of the Hermitage" and mail it to our office at:

Canadian Friends of the Hermitage
Ottawa Chapter - Lecture Series
280 Metcalfe Street, Suite 400
Ottawa, Ontario
Canada  K2P 1R7

• I/We wish to register for the full series of five lectures.
  • My/Our membership number is/are: __________
    My/Our cheque for $30 per person is enclosed, for a total of $____________
    
    
  • I am not a member. My cheque for $75 per person is enclosed, for a total of: $____________
    
    
• Tickets for individual lectures may be purchased separately. They are priced at $10 each for members and $15 each for non-members.

  I wish to purchase tickets for the following lectures:
  
  Sept. 29 - "The Golden Age of Dutch Painting"  _____ tickets
  
  Oct. 13 - "Decorative Arts"                    _____ tickets
  
  Oct. 27 - "Lorenzo Lotto and Chardin"          _____ tickets
  
  Nov. 10 - "Icons"                              _____ tickets
  
  Jan. 19 - "Matisse"                            _____ tickets

Please mail the tickets to:

Name: ____________________________________________________________________

Address: _________________________________________________________________

Address: _________________________________________________________________

City: ______________________ Province: ___________ Postal Code:___________

Telephone: (___)_________ E-mail address: ________________________________