Request membership information and brochure

Name:

Street Address:

City: State: Zip:

Phone:

Cell Phone:

E-mail:

Work E-mail:

(List only if we can contact you there)

I would be interested in helping in the following ways: (check all that apply)

Acting	Sound	Make-up/Hair
Singing	Props	Play Reading
Music/Musician	Publicity	Membership
Set/Construction	Tickets	Fund-raising
Painting/Design	House/Ushering	Clerical
Lights	Costumes
Other -