Bellport Playcrafters - Bellport's OTHER Live Theatre

Name: ____________________________________________________

Address: _________________________________________________

____________________________________________________

Phone ____________________________________________________

Email ____________________________________________________

TYPE OF MEMBER SHIP:
[__] Single - $15.00
[__] Couple - $25.00
[__] Sponsor - $35.00 & up
[__] Angel - $50.00 & up
[__] Patron - $100.00 & up

PLEASE CHECK ONE:
[__] Always notify me by US mail
[__] Email is good enough

Please make checks payable to:
Playcrafters
P.O. Box 452
Bellport, NY 11713