Bridal Show Date/Location:           April 25, 2010 Long Beach Convention Center

Bride's First Name:          

Bride's Last Name:           

Address:                               

City:                                     

State:                                           Zip:     

Telephone:                         

Cell Phone:                         

E-mail:                                

Wedding Date:  (--/--/--) 

How did you hear about the Bridal Show?

Number of Tickets:     

Total ($5 per ticket):  

Payment Method:         Visa Mastercard Discover American Express Cash Check

Credit Card #:   

Expiration:            V Code:

I hereby authorize the above credit card to be billed in the amount of  $

Signature:        Date: