Chad Brannon Fan Club Event 2004 PLEASE PRINT OUT, COMPLETE ENTIRELY, AND SEND THIS FORM WITH YOUR PAYMENT. MONEY ORDERS ONLY-No other forms of payment will be accepted Yes, count me in! Please reserve ______ tickets(s) at $55.00 per person. Name:____________________________________________ Tel: (___) _______________________ Address:_________________________________________________________ Email address: ________________________________ Screen Name (at Chad's message board):___________________________ Money Order # __________________ Total amount $____________________ Please make all money orders payable to: Wingspan Productions and send all ticket requests to: Chad Brannon Fan Club Event 2004 Wingspan Productions PO Box 223372 Chantilly, VA 20153-3372 Attire for the evening: TBA Two self-addressed stamped envelopes & the names of all those attending in your group must accompany all ticket requests.

Additional Attendees Please include the names of all parties you are purchasing tickets for here so that you may all be seated together at the event. Name:__________________________________________________ Screen Name (at Chad's message board):___________________________ Name:__________________________________________________ Screen Name (at Chad's message board):___________________________ Name:__________________________________________________ Screen Name (at Chad's message board):___________________________ Name:__________________________________________________ Screen Name (at Chad's message board):___________________________ Name:__________________________________________________ Screen Name (at Chad's message board):___________________________ Name:__________________________________________________ Screen Name (at Chad's message board):___________________________ Name:__________________________________________________ Screen Name (at Chad's message board):___________________________