Membership Registration

REGISTRATION FORM

2012 MEMBERSHIP APPLICATION
valid one year to date:

Date *

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Individual Levels *

Understudy - $10.00 Seniors/Students (18 years or over) Actor - $30.00 (Single Membership) Duet - $40.00 (Couple Membership) Troupe - $60.00 (Family Membership)

Total Payment *

Payment Method *

Cash Cheque Other

I wish to volunteer selling memberships at events *

Yes No

Membership Card: Issued to applicant - sent by mail to applicant

Submit

REGISTRATION FORM

2012 MEMBERSHIP APPLICATIONvalid one year to date:

2012 MEMBERSHIP APPLICATION
valid one year to date: