Note: Print this form and fill it out. Send it along with your check or money order for the trip to the address below.

NAME:

ADDRESS:

PHONE:

Number of Complete Trip Packages: ______ X $385.00 = $
(Includes air fare, game ticket, events and chartered bus transportation to and from the game)

Number of Game Tickets & Events: ______ X $120.00 = $
(Includes everything except air fare)

Total this order: $

(Check or money order only. No cash. Payment must be received by Aug. 10)

Trip reservations may be made by phone but payment must be received within 10 days of the call. Call Jim Day at (410) 604-0750 to reserve your trip.

List all names in your party receiving Southwest Airline tickets (enclose additional sheet if necessary)

1. NAME: ____________________________________________________________________

ADDRESS: ___________________________________________________________________

2. NAME: ____________________________________________________________________

ADDRESS: ___________________________________________________________________

3. NAME: ____________________________________________________________________

ADDRESS: ___________________________________________________________________

4. NAME: ____________________________________________________________________

ADDRESS: ___________________________________________________________________

5. NAME: ____________________________________________________________________

ADDRESS: ___________________________________________________________________

6. NAME: ____________________________________________________________________

ADDRESS: ___________________________________________________________________

Room reservations for the New Orleans Airport Hilton (optional):

Please reserve ________ room(s) in my name for Friday night, ________ room(s) for Saturday night and ________ room(s) for Sunday night. (Do not send payment for the rooms. Payment will be made directly to the Hilton. - ($92.00 plus tax up to 2 persons per room/per night or $112.00 plus tax more than 2 per room/per night)

Rooms will need to be reserved under you personal credit card after August 10 by calling the Hilton reservation desk at (504) 469-5000. Tell them you are with the Pittsburgh Steelers Fan Club of Baltimore, Md. to get the group discount.

Make checks payable to: Pittsburgh Steelers Fan Club. Send to:

Jim Day
1715 Harbor Dr.
Chester, Md. 21619

PHONE: (410) 604-0750

All of the details for this exciting trip will be mailed well in advance of the trip.

Return to the PSFCOB website.