Booking Information UNIVERSITY THEATRE SERVICES

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1 UNIVERSITY THEATRE SERVICES Booking Information Please read through the following pages and return the enclosed forms no later than eight weeks prior to your event.

2 General Information Copyright Permission Royalty payment and copyright clearance is the sole responsibility of the renter. The renter must accept all responsibility for and absolve the University of Calgary from any liability or expense arising out of the use of any composition, work or material covered by copyright. Copyright permission must be received from the appropriate collective for the public performance of both live and recorded music. SOCAN ( - licenses material your group will be performing or will be playing via CD, ipos, etc. This collective manages royalty payments to the lyricist(s) and songwriter(s). RE:SOUND ( - licenses recorded music for public performance. This collective manages royalty payments for the recording artist(s) and record companies. Public viewing of film and video must have the authorized consent of the copyright holder(s). All publicly viewed film and video must be rated, unless exempted, by the Alberta Film Classification ( Lost and Found All lost and found items are kept for 30 days after the event. Please call us at during regular business hours. Event Quotation We can offer you guidance on pricing, but the actual costs of your event will vary depending on your needs during occupancy, so we cannot offer guaranteed estimates. For meetings and conferences, you may need to budget for AV equipment. If your booking occurs outside business hours, it will also require a conference attendant. Performance events require technicians and front of house staff, whose labour costs depend on the nature of your booking, and how long they are required to be onsite. For performances please contact our Stage Manager who can provide an estimate on technical labour and materials and our Front of House Manager for an estimate for front of house labour, ticket printing and sales commissions. Please refer to our website for pricing information. Please note that in the absence of a booking or a hold, availability is subject to change without notice. Parking and Transit Parking on campus is operated by Parking Services ( or ). University Theatre Services does not control any loading dock or parking area adjacent to our theatres. We suggest that patrons use the Arts Parkade. The parkade is accessible from 24th Avenue NW and Campus Gate NW. Directional signage to all of our venues is located on the +15 walkway. Calgary Transit provides service by Red Line C-Train and bus routes 9, 19, 20, 31, 72 and Car2Go vehicles have been allocated 16 stalls on Level 1 in the Arts Parkade. For taxi drop off and pick up the address for the Rozsa Centre is 206 University Court NW. The University Theatre is 230 University Court NW. Smoking The University of Calgary is a smoke free environment which includes all forms of e cigarettes. Campus Maps Maps of the University of Calgary can be found at Contacts Address: CHG University Drive NW Calgary, Alberta, T2N 1N Website: Fax: Business Hours: Monday to Friday - 8:30 to 4:30 Closed weekends, holidays and between Dec 25 to Jan 1. Bookings and Ticketing: booking@theatreservices.ca Technical: Graham Frampton technical@theatreservices.ca Front of House: Lizzy Evashkevich foh@theatreservices.ca Accounts: Gwen McGowan billing@theatreservices.ca Rozsa Centre Event Coordinator: Ian Kelly meetings@theatreservices.ca Manager: D.W. von Kuster manager@theatreservices.ca Payment of Fees Payment of deposit and the final invoice can be made by cash. cheque, or credit card. Cheque payments must be made out to the University of Calgary. Post dated cheques are not accepted. Client will be charged a $25.00 NSF fee for any dishonoured cheques. This fee is subject to change without notice.

3 Front of House Front of House Staff We provide a House Manager, ushers, concession attendants and box office cashier. Hourly and overtime rates apply. Current rates are indicated on the front page of your lease. Ushers collect tickets, distribute programs, assist patrons in finding seats, operate coatcheck service (when weather dictates), set up merchandise and reception tables. A fifteen minute break is required for all staff no later than three and a half hours of continuous labour. A unpaid meal break is required for all staff after five hours of labour. Please confirm all front of house requirements no later than four weeks prior to your event with our Front of House Manager. Concession Services All concession food and beverage sales must be conducted by University Theatre Services. Concession service consists of coffee, pop, juice, bottled water, beer, wine and light snacks. For additional information on our concession services please contact our Front of House Manager. If concession service is requested a minimum of $ of concession sales will be required. If sales are less than $100.00, you will be billed the difference. Alcohol must be purchased at our concession and consumed within the lobby operated by University Theatre Services. The public consumption of alcohol in any other area is strictly prohibited. Length of Performance Performances cannot exceed four hours in length (intermission included) without advance notice. Second performances on the same day must have at least two hours between the end of the first performance and the start of the second performance. Merchandise Sales Please ensure to contact our Front of House Manager no later than four weeks before your event to discuss any merchandise sale requirements. The client is responsible for all aspects of merchandise sale activity within our venue. All display and merchandise sales are subject to approval by Theatre Services. Pre / Post Show Receptions We would be pleased to discuss all of your options. Additional rental and labour rates may apply and only University of Calgary approved caterers may be utilized. Please contact our Front of House Manager to discuss your options. Programs Any programs required to be distributed to your patrons must be given to your House Manager no later than one hour before showtime. Please ensure any inserts have already been stuffed into the program. Publicity Patrons call us frequently looking for event information. We ask that you provide us with information for your event including a contact from your organization. A Poster can be displayed, space permitting, in our lobby prior to your event. You can deliver your poster to our main office located in Craigie Hall room G205. Ticket Policies Ticket printing and sales must be conducted through University Theatre Services. Online ticket sales will go off sale three hours prior to the start of your performance. Pre-ordered tickets will be held at the venue s will call for pick up. All will call tickets must be picked up by the credit card holder. Unsold tickets may also be made available for sale one hour before the performance. Our on site box office opens one hour before the performance and closes 30 minutes after the start of the performance. Ticket sales are final. No exchanges or refunds for purchased tickets. Box Office Payment Methods Online ticket sales accept Visa and Mastercard only. Debit cards, including Visa debit cards are not accepted. Box office sales accept Visa, Mastercard, Amex, Debit and Cash. Personal cheques are not accepted at the box office. Wheelchair Seating All venues are wheelchair accessible and patron drop off locations are located outside of each venue. For advance notice and inquiries please call our Front of House Manager.

4 Technical Information Production Needs Please confirm all technical requirements no later than four weeks prior to your event with our Stage Manager. We will be requiring information such as equipment needs, proposed schedule(s) and technical requirements (sound, lights and stage). Length of Performance Performances cannot exceed four hours in length (intermission included) Second performances on the same day must have at least two hours between the end of the first performance and the start of the second performance. Technician Call Times Please allow at least thirty minutes between your arrival time and rehearsal time if no setup is required. Please review your needs with our Stage Manager no later that four weeks prior to your event. Technicians are required to be in the facility at least one hour prior to your performance. A fifteen minute break is required for all staff no later than three and a half hours of continuous labour. A unpaid meal break of one hour is required for all staff after five hours of labour. Special Effects Please consult with our Stage Manager about any special effects such as fog, haze, strobe lights and open flame. Any and all costs associated with any required control measures are assumed by the client. Many of these effects are governed by governmental legislation and established university policies and procedures. Fog and haze effects are restricted to use within certain areas of our facilities and the client is liable for any City of Calgary charges due to accidental fire alarms caused by fog/ haze effects. The use of pyrotechnical effects is prohibited in our facilities. Firearms The use of firearms must comply with all federal and provincial legislation as well as university policies and procedures. Please consult with our Stage Manager about your needs. Set If you have a set, please bring it to the attention of of Stage Manager. Sets must be constructed using materials that are fire resistant and are constructed in a manner that will not be a safety hazard. Cardboard sets are not allowed on stage due to fire regulations. Set construction is limited at our facilities. Major construction should be completed before move in. The university cannot provide any tools and hardware for your scenery. If you plan on any construction or painting in our facility please discuss your needs with our Stage Manager before move in. Please note that articles known to cause allergic responses are restricted from our venue. This includes but is not limited to hay and straw. Sets and props must be moved out of the facility at the end of your last performance day. Sets cannot be disposed in University of Calgary dumpsters. Lighting Requirements Each facility has a house plot that normally meets the needs of our clients. If you need additional lighting, we will need to allocate additional time to your set-up and strike in order to add additional fixtures to our plot. Information on our house plot and inventory can be found on our website at or by contacting our Stage Manager. On average, each lighting fixture takes ten minutes to hang and five minutes to remove. Please plan for each lighting cue to take five minutes to develop from start to end. In order to ensure that you have scheduled enough time please contact our Stage Manager of your lighting needs no later than four weeks prior to your event. Most of our lighting equipment is included in your booking rental fee. Materials such as gel, gobos, third party rentals or any other direct material costs may be subject to an additional fee. For more information please consult with our Stage Manager about these costs. Sound Requirements Each facility is equipped with an audio system that regularly meets the needs of our clients. Information on our audio system can be found on our website at or by contacting our Stage Manager. If you are planning to reinforce the performance with the addition of microphones, such as a live band or musical, the audio console may be required to be placed in the house. Our audio technician will be required to be placed in the house in order to properly mix your performance. Please consult with our Stage Manager before you complete your ticket request form in order to ensure that the appropriate seating has been held for this activity. Most of our audio equipment is included in your booking rental fee. Items such as wireless mics, stage monitors, third party rentals or any other direct material costs may be subject to an additional fee. For more information please consult with our Stage Manager about these costs. Smoking The University of Calgary is a smoke free environment which includes all forms of e cigarettes.

5 Rates - as of Sept 1, Prices subject to change. Labour Charges Front of House Manager $20.50/hr Usher $20.50/hr Technician $40.00/hr Room Set-up $40.00/hr Room Attendant $20.50/hr Overtime rate is 1.5 times the normal hourly rate after seven (7) hours of labour. Holiday rate is 1.5 times the normal hourly rate. Labour Requirements An overtime fee of 1.5 times the normal hourly salary will apply after a seven-hour shift. A fifteen minute break is required for all staff no later than three and a half hours of continuous labour. A unpaid meal break of one hour is required for all staff after five hours of labour. If you require any hours above 12 hours in a day you will need to discuss your plans with our Stage Manager. Employees cannot work more that 12 hours in one day, including breaks. As an example an employee that starts their shift at 8:30am can only work until 8:30pm that evening. Staffing Complement The normal staffing complement per performance is indicated below. Due to the nature of your event we may require additional staff. Please talk to both our Front of House Manager and Stage Manager for additional information. University Theatre 3 Technicians 1 Front of House Manager 5 Ushers Eckhardt-Gramatté Hall 2 Technicians 1 Front of House Manager 4 Ushers Boris Roubakine Recital Hall 1 Technician 1 Front of House Manager 2 Ushers Stage Supplies Data Projector - $200/day Rear Projection Screen - $150/day Fog Machine - $30/day Hazer - $30/day Dance Floor - $150/day Dance Floor Tape - $25/day Piano - $35/day Piano Tune - $175/per tune Wenger Staging Risers - $50/day Sound Equipment Wireless Mic - $30/day Stage Monitor - $30/day Meyer MTS4 (pair) - $100/day Mixer - $50/day Recordable CD - $5/each USB Stick - $10/each AA Battery - $1/each 9V Battery - $4/each Conference Supplies Data Projector - $200/day 8 Screen - $30/day Rear Projection Screen - $150/day Wenger Staging Risers - $50/day Wireless Mic - $30/day Stage Monitor - $30/day CD Player/Recorder - $10/day Recordable CD - $5/each Mixer -$30/day Computer - $75/day Computer Speaker - $20/day Presentation Remote - $10/day Television - $30/day Blu-Ray Player - $20/day Mini Player -$20/day Flip Chart - $15/day Easels - $5/day Audio Visual Cart - $10/day Photocopies - $0.15/page Fax -$0.50/page Table Cloth / Skirt - $25/day Ticket Charges Service Charges to Client 6% commission charge on all sales - minimum $ % service fee on credit card sales $0.50 per ticket for distribution of complimentary and promoter tickets on the sponsor s behalf (limit 100 tickets) $2 Vendini patron service fee per ticket - fee will be built into the ticket price. Additional fees and regulations will apply if you require all tickets to be printed and to be sold offsite. Tickets must be printed as reserved seating. A ticket printing fee of $.50 will apply to all tickets printed. A 6% commission fee on the highest ticket face value multiplied by the actual attendance. If any tickets are returned for sale at the door a labour fee of $40.00 per hour (minimum fee $120.00) will be applied to place the tickets back into the ticketing system. All returned tickets must be returned no later than two business days before your performance. GST 5% GST will be added to all charges. It is the sole responsibility of the renter to remit all applicable GST from revenue that was generated during your stay at Theatre Services. University Theatre Services will not remit GST on your behalf.

6 Safety Emergency Phone Numbers Police, Fire, Ambulance: 911 Campus Security: Rozsa Technician: University Theatre Technician : If you do call 911, please call Campus Security afterwards to inform them of the incident. Evacuation Procedures If there is an alarm, the facility must be immediately evacuated. 1. Activate the nearest fire alarm pull station, located along exit path, if the alarm has yet to be activated. 2. Evacuate building through the nearest exit. Use stairs. Do not use the elevator. 3. Close doors along the exit route. 4. If directed by emergency wardens, follow their directions. 5. Proceed to your assigned assembly point 6. If you have further information about the emergency please call Campus Security at Emergency Assembly Points Assembly points have been selected as they are large enough to hold a significant number of people and will provide an evacuated population access to washroom facilities and protection from the elements. Assembly points are also designed to establish a location for information updates from the emergency responders to the evacuees. Please refer to the attached map(s) to this booklet to locate your assembly point. Rozsa Centre University Theatre Lobby - Craigie Hall G Block University Theatre Professional Faculties Food Court Boris Roubakine Professional Faculties Food Court Emergency Wardens Emergency wardens will assist in the evacuation of campus facilities. An orange reflective vest will be worn by all wardens in order to facilitate easy identification. During an alarm, your emergency wardens will be the employees assigned to your booking. For performances the Stage Manager and the House Manager will be your primary wardens. For meetings and lectures in the Rozsa Centre your primary warden will be the facility attendant. All users of our facilities are required to follow the direction of the emergency warden. Do not re-enter the facility under any circumstances until the all clear has been given. First Aid First Aid Kits are located in the following locations. All incidents must be reported to an employee of Theatre Services. Rozsa Centre Stage Manager Office - RC 117 Box Office - RC 105 University Theatre Box Office - CHF 109 Technician Office - CHG 125 Stage Right - CHG 122 Stage Left - CHG 102 Main Office - CHG 205 Boris Roubakine Recital Hall Box Office - CHC 110A All Campus Security officers and a variety of employees of Theatre Services are certified to provide first aid. Incident Reporting Visitors must report any accident, injury, unsafe condition, near miss or safety concerns to an employee of Theatre Services. Emergency Exits Emergency exits are located throughout each facility. Please review the attached map(s) in order to familiarize yourself with their locations. Emergency exits are identified by lit signage above the doorway. All emergency exits must be kept clear at all times. Emergency Pull Stations Emergency pull stations, fire alarm pull stations, have been placed near doorways and in hallways that have been identified as an emergency exit. When you arrive at our facility please review the location of these pull stations. Fire Safety Please consult with our Stage Manager about any special effects such as fog, haze, strobe lights and open flame. Any and all costs associated with any required control measures are assumed by the client. Many of these effects are governed by governmental legislation and established university policies and procedures. Emergency pull stations, electrical panels and emergency exits (including hallways that lead to an emergency exit) must be kept clear at all times. If you have any questions or concerns please bring it to the attention of an employee of Theatre Services. UCalgary Safety Policies For further information on UCalgary safety policies and procedures please visit

7 FAQs 3 WEEKS AFTER RECEIVING LEASE Please review your lease and return a signed copy back to Theatre Services within three weeks after receiving the lease. A signed lease and a deposit will officially confirm your booking with us. If paying by cheque please make it out to the University of Calgary. Ticket printing and online sales cannot occur until a deposit and lease have been received. If you have any questions please call or billing@theatreservices.ca. 8 WEEKS UNTIL YOUR EVENT Please return your ticket information form, front of house information form and technical information form within eight weeks of your event. We require the information in these forms to plan for appropriate staff levels, technical requirements, set-up and sale of tickets and any other matters that may require some time to prepare. 4 WEEKS UNTIL YOUR EVENT Please make direct contact with our Front of House Manager and Stage Manager within four weeks of your event. We need to review your requirements at this time in order to ensure a successful booking. Our Front of House Manager contact is or at foh@theatreservices.ca Our Stage Manager contact is or at technical@theatreservices.ca 2 WEEKS AFTER YOUR EVENT An invoice will be created two weeks after your event and sent to your business address listed on the signed lease. If you require an electronic copy please feel free to contact us at or by at billing@theatreservices.ca. If a balance remains a refund will be processed at this time and sent out to the business address listed on the signed lease. 6 WEEKS AFTER YOUR EVENT Payment should be completed by this time if an amount is owing to the University of Calgary. If a balance was remaining after your event a direct deposit into your account (if provided) or a cheque mailed to your business address would have been completed. If you require further information please call us at or by at billing@theatreservices.ca. How late can I cancel my event? Your event can be cancelled up to three months in advance with no penalty. Should you cancel within three months of the date of occupancy, or fail to appear, any deposit made will not be refunded. Can I print my own tickets? All tickets must be printed and sold by Theatre Services. If you have special requirements please contact our Front of House Manager at or by at foh@theatreservices.ca to discuss your needs. When can I start selling tickets? We require a signed lease and a deposit to be made to the University of Calgary before ticket sales can occur. Please note we must receive your ticket order form at least two weeks before your tickets are expected to go on sale. Can my event be catered? The University of Calgary has an on site caterer that can provide catered service for your event. Please contact our Front of House Manager at or by at foh@theatreservices.ca for further information. Can I get a quote for my event? We can offer you guidance on pricing, but the actual costs of your event will vary depending on your needs during occupancy, so we cannot offer guaranteed estimates. Please contact our Stage Manager at or by at technical@theatreservices.ca for technical material and labour costs. Please contact our Booking Coordinator at or by at booking@theatreservices.ca for front of house labour, tickets printing and commission.

8 Emergency Evacuation Procedures A. Activate the nearest fire alarm pull station along exit path. B. Take coat and keys if immediately available. C. Evacuate building through the nearest exit. Use stairs, do not use elevators. D. Close all doors along your exit route. E. Move away from the building & proceed to Assembly Point If you have information regarding the emergency call Campus Security at from a safe location Evacuation Assembly Point Craigie Hall G (CHG) MC MLT TFDL KN CHG CHF CHC CHE CHD RC IH RT AB Building You Are In Assembly Point During an Emergency Rozsa Centre (RC) IH ucmaps@ucalgary.ca Nov 5, 2012 RT Legend Rooms Washrooms Elevators Floor: 01 Staircases Hallways! You Are Here

9 Emergency Evacuation Procedures A. Activate the nearest fire alarm pull station along exit path. B. Take coat and keys if immediately available. C. Evacuate building through the nearest exit. Use stairs, do not use elevators. D. Close all doors along your exit route. E. Move away from the building & proceed to Assembly Point If you have information regarding the emergency call Campus Security at from a safe location Evacuation Assembly Point Professional Faculties (PF) MH MLB A TFDL MLT PF CHG MFH EDT CHF CHC EDC CHE CHD RT AB Building You Are In Assembly Point During an Emergency Craigie Hall G (CHG) CHF ucmaps@ucalgary.ca Dec 14, 2012 TFDL Legend Rooms Washrooms Elevators Floor: 01 Staircases Hallways! You Are Here

10 Emergency Evacuation Procedures A. Activate the nearest fire alarm pull station along exit path. B. Take coat and keys if immediately available. C. Evacuate building through the nearest exit. Use stairs, do not use elevators. D. Close all doors along your exit route. E. Move away from the building & proceed to Assembly Point If you have information regarding the emergency call Campus Security at from a safe location Evacuation Assembly Point Professional Faculties (PF) MH MLB A TFDL MLT PF CHG MFH EDT CHF CHC EDC CHE CHD RT AB Building You Are In Assembly Point During an Emergency Craigie Hall G (CHG) CHF ucmaps@ucalgary.ca Dec 14, 2012 TFDL Legend Rooms Washrooms Elevators Floor: 02 Staircases Hallways! You Are Here

11 Technical Information Form Graham Frampton t f technical@theatreservices.ca On Site Contact: Phone: E Mail: Cell: Other: If the On Site Contact is not authorized to make decisions that may incur additional costs please include the contact who is below: Contact Name: Phone: Schedule of Events - for multiple day bookings please attach additional pages. Please note schedule cannot exceed 12 hours after your start time without approval from our Stage Manager Arrvial/Set-up Start Time Rehearsal Start Time Performance Start Time Set-up End Time Rehearsal End Time Performance End Time Notes: Stage Requirements Choir Risers: : Yes No Staging Risers: Yes No Dance Floor: (Rental Fee Applies) Yes No Hanging Drops/ Banners: Yes No Piano: (Rental Fee Applies) Yes No Special Effects: (Fog, Haze...) Yes No Notes: (Set, Holding Rooms, ect ) Memo Code: Date: Page 1 of 6

12 Technical Information Form Graham Frampton t f technical@theatreservices.ca Lighting Requirements General Lights: (No Specials) : Yes No Data Projector: (Rental Fee Applies) Yes No Computer: (Rental Fee Applies) Yes No Video: (Fees May Apply) Yes No Lighting Cues: Yes No How Many? (3 to 5 min per cue) Lighting Specials: Yes No How Many? (5 to 10 min per light) Notes: Sound Requirements Audio Playback Yes No Laptop, CD, Other: Record Event for Client Yes No Stage Monitors: (Fees May Apply) Yes No Vocal Mics (How Many) Instrument Mics (How Many) Depending on your audio needs a Front of House mix may be required. This will require a few seats in the house to be reserved for the audio mix. Please consult with your Stage Manager to determine the proper technical needs before seats are placed on sale to the general public. Notes: Notes: Memo Code: Date: Page 2 of 6

13 Front of House Information Form Lizzy Evashkevich t f foh@theatreservices.ca Contact Name: Phone: E Mail: Performance Information for multiple day bookings please attach additional pages. Intermission: : Yes No How Many: Length: Act 1 Length: Act 2 Length: Act 3 Length: Patron Policies Can pictures be taken? Yes No Flash photography? Yes No Can video be taken? Yes No Would you like a pre show announcement to be made indicating these choices with the audience? Yes No When will you allow latecomers to enter the performance? Please pick one choice. Between pieces at the back of the house Between pieces in reserved seats As they arrive at the back of the house As they arrive in reserved seats Do you require any seats to be reserved for performers or special guests? Yes No Number of seats required: Required section or row: Programs Will programs will be supplied for the event: Yes No Notes: Memo Code: Date: Page 3 of 6

14 Front of House Information Form Lizzy Evashkevich t f foh@theatreservices.ca Concession and Bar Service - $ minimum sales required Please check all that apply: Concession Service: Before Event: Intermission: After Event: Lobby Requirements For special requests concerning concession services please contact our Front of House Manager Do you require tables Yes No How Many Please provide further information on your lobby set-up and how many tables you require for each use. (i.e. catering, sales, registration) Receptions Reception before event Yes No Reception after event Yes No Provide us details of your reception including the name of the caterer, set-up requirements and access time. Please note that the university s caterer, Aramark, has exclusive catering rights for events in the Rozsa Centre. Memo Code: Date: Page 4 of 6

15 Ticket Information Form t f tickets@theatreservices.ca Contact Name: Phone: E Mail: Venue Capacities: University Theatre Eckhardt-Gramatté Hall Boris Roubakine Recital Hall 205 Ticket Information - Please check all that apply Unreserved Seating: : Total Tickets Required: Promoter Tickets: (Max 100) Complimentary Tickets: Yes No Reserved Seating: Yes No On Sale Date: Date Required: Date Required: Online Ticket Sales: Yes No On Sale Date: Sell Remaining Tickets at Door Yes No Door Sales Only: Yes No Are you requiring the use of microphones for vocals or musical instruments on stage? Yes No If you require the use of microphones on stage to reinforce vocalists or musicians we may require additional seating to be reserved for the placement of an audio board in the house. If you do require microphones please consult your needs with our Stage Manager before completing this form. Admission Charges - Default ages are Children 18 and Under / Seniors 65 and Over General: : Advance: $ Door: $ Student: Age: with ID Advance: $ Door: $ Senior: Age: and Over Advance: $ Door: $ Child: Age: and Under Advance: $ Door: $ Member: Advance: $ Door: $ Group: How Many? Advance: $ Door: $ How would you rate your show? General - PG A - R Memo Code: Date: Page 5 of 6

16 Ticket Information Form t f tickets@theatreservices.ca Ticket Printing Information PLEASE PRINT EXACTLY WHAT YOU WOULD WANT TO SEE ON YOUR TICKET Sponsor / Presenter: Event Name Location Date: Time: Would you like to see a proof* before ticket printing occurs? Yes No Please provide an for the ticket proof*to be sent to: *Printing will not begin until the proof has been approved. Online Promotional Information Correct Information Acknowledgement I have read and agree to all the terms mentioned above. All of the information I have provided is correct and you understand that additional printing and service charges may apply if changes are required after the initial printing. Signature: Date: Memo Code: Date: Page 6 of 6

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