Shades of Green® on WORLD® Resort an Armed Forces Recreation Center

AMIM-WRH-S-AT For Office Use Only:

MEMORANDUM FOR RECORD

SUBJECT: Advanced Ticket Order Form

Last Name: First Name: Rank/Status:

ID Expiration: Email Address: Travel Date:

By submitting this request you certify the above information is true and that you are currently Active Duty, a Retired member of the Armed Forces, Department of Defense Civilian employee, the current spouse of an Active Duty, Retired, or Reservist in Active status, have a VHIC identification card. It is a federal offense (818 USC Sec. 1343) to wrongfully obtain government services/privileges under false pretenses, which is punishable by fines and imprisonment for up to 20 years.

Please fill in the below information and email to [email protected] or fax to (407)824-2100. All ticket sales are non-refundable and non-transferrable. Shades of Green is not responsible for lost or stolen tickets.

Number Park Ticket of Price Per Ticket Total Amount Tickets Example: 4-Day Park Hopper Military Promotional Ticket 2 $ 291.75 $ 583.50

Shipping Fee $12.00 Total Due It is your responsibility to verify eligibility to purchase tickets based on your status. Tickets are non-refundable.

I, ______confirm that I am the Eligible Service Member or spouse and authorize Shades of Green’s Attraction Sales Office to charge my credit card for the amount listed above.

Name on card: (Must be service member or current spouse) Billing address: City: State: Zip Code: (No P. O. Boxes) Last 4 Digits of Credit Card: Expiration Date: CVV:

Contact number: Best time to call:

Physical Signature: ______Date: ______(Digitally signed using your CAC is acceptable)

For additional information about , Universal Orlando, SeaWorld Orlando please visit the following websites: www.waltdisneyworld.com www.universalorlando.com www.seaworldorlandolcom Post Office Box 22789, Lake Buena Vista, 32830-2789  (407) 824-6191  (407) 824-2100 (fax) “Serving Those Who Serve”