Kenmore Teachers FCU

Kenmore Teachers Federal Credit Union

Member Annual Meeting Ticket Order Form
Applicant Name*

First NameLast Name
Applicant Account Number*
This is the account number you want to have funds deducted from to pay for this ticket order.
Applicant Email*
example@example.com
Number of Member Tickets*
Member Ticket Amount
Tickets are $15.00 per person.
Number of Non-Member Tickets
Tickets are $20.00 per person.
Non-Member Ticket Amount
Order Date*

MonthDayYear
This is the dollar amount that will be deducted from the account you provided above for the ticket purchase(s).
Total Annual Meeting Ticket Order
This is the dollar amount that will be deducted from the account you provided above for the ticket purchase(s).
How do you want to receive your ticket(s)?*

Interoffice MailPickup at the KTFCU OfficePickup at the Door
If you have ordered more than one ticket, please provide the names of your guests.

Note, a table will not be reserved for your group. The purpose of names is for the attendance log only. Doors open at 4:00pm; please arrive early to save seats.
Guest Name #1

First NameLast Name
Guest Name #2

First NameLast Name
Guest Name #3

First NameLast Name
Guest Name #4

First NameLast Name
Guest Name #5

First NameLast Name
Guest Name #6

First NameLast Name
Guest Name #7

First NameLast Name
Guest Name #8

First NameLast Name
Guest Name #9

First NameLast Name
Acknowledgement of Payment Amount to be Deducted from Your Account.*

By submitting this Annual Meeting Ticket Order form, I authorize the KTFCU to withdraw the dollar amount specified above from my account (also provided above).
Please verify that you are human*
Should be Empty:

Kenmore Teachers Federal Credit Union

This is the dollar amount that will be deducted from the account you provided above for the ticket purchase(s).

If you have ordered more than one ticket, please provide the names of your guests.

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