MTAC MCINTOSH THEATRE ARTS COMPANY
Membership
MEMBERSHIP APPLICATION
INDIVIDUAL MEMBERSHIP: $10 PER YEAR
(JAN THRU DEC)
Print a copy of this form for each individual, complete the application(s) and forward with your check for the appropriate amount to:
McIntosh Theatre Arts Company Inc.
Nila Geiger, Membership Director
CHECK ONE: NEW____ RENEWAL ____
DATE
NAME
ADDRESS
ADDRESS
CITY STATE ZIP
HOME PHONE
DAYTIME PHONE
CELL PHONE
EMAIL