Fax Request for Tickets
For THE HISTORY (And Mystery) OF THE UNIVERSE

Print this form and fax to:
The Mercury Theater    FAX: 773-___ ____
3745 North Southport, Chicago 60613


Today's Date:  ________________

Date of Show:  ____________ Time of Show: ____________

Number of
Tickets

 
Price Per Ticket
 
Totals
_________
x $ _______ = $_________  
_________
x $ _______ = $_________  
________
x

$2.75 per ticket
Service Charge

+ $_________ Service
charge

TOTAL CHARGE

$_________

Ticket Prices:
Tues, Weds, Thurs and Sunday evenings: $29.50
Friday, Saturday, and Sunday matinee: $36.50.

The Box Office accepts Visa, Master Card, American Express

Name on Card: ________________________________________

Credit Card #: _________________________________________

Credit Card Expiration Date: ________________

Mailing Address:_______________________________________
                                                                                    City   ZIP
Signature (authorizing charge)________________________________

Daytime Phone: (_____)_________________________________

E-Mail Address: _______________________________________

The Box Office will mail tickets for orders placed more than 10 days in advance of the show. For orders placed less than 10 days ahead, pick up your tickets at "Will Call" at the theater box office on the night of the show, at least 30 minutes before curtain time.

Questions for the Box Office? Call them at 773-325-1700.
You can also use this form if you want to pay via check. Mail the form and your check to Mercury Theater Box Office,
3745 North Southport, Chicago 60613