Public Day Ticket Sale Form

Guest Name:________________________________________________

Address:___________________________________________________

__________________________________________________________

___________________________________________________________

Phone Number:______________________________________________

E-mail:____________________________________________________

Number of Tickets: ___________________

_______Check (payable to Walt Disney Event Services): __________

Credit Card Information:

AMEX_______VISA_______MC_______The Disney Card_______

JCB_______Discover_______Diner's Club_______

Card Number: ______________________________________________

EXP: ______________

Amount to be Charged: ______________________

Signature of Cardholder: _________________________________________

Billing address: ________________________________________________

(if different from above)

To register by phone or for more information, call us at:
(407) 827-7600

Or contact us by e-mail at:
WDW.Disneyana.Convention@Disney.com

Send the completed form to:
Walt Disney Event Services
Official Disneyana Convention
Post Office Box 10345
Lake Buena Vista, FL 32830

Or fax it to:
(407)566-1387

Remember: If you are under 18 years of age, you must have your parent or guardian's permission to dial this number.