Fastening your original "Bloody Sunday" movie ticket to the form as indicated below, and mailing it to "Bloody Sunday" Promotion, GAR Media, 38-11 Ditmars Blvd, #193, Astoria NY 11105-1803 OR via fax to 631-207-0448.

Name:        _______________________________________

Address:    ______________________________________

                  ______________________________________

                  ______________________________________

Day Time Phone Number:     _____-_____-_________

eMail Address:    ___________________________@___________________