2008-2009 Season FlexPass Order Form

Date:
Name:
Street Address:
City, State, Zip Code:
Email Address:
Home Phone:
Work Phone:
 
Please add my name to the CT EMAIL list.
     Yes No

Please contact me during the next Season FlexPass drive.
     Yes No

Please consider helping CT by purchasing at one of our Contributor Levels:
Contributor Level How Many What You Get
Benefactor $500 x  10 FlexPasses
Director $350 x  8 FlexPasses
Producer $250 x  5 FlexPasses
Angel $175 x  4 FlexPasses
Thespian $150 x  3 FlexPasses
Patron $100 x  2 FlexPasses
Contributor Levels:
Print your name below as you would like it to appear in our program book:

OR

Order Season FlexPasses
Type Price Number of FlexPasses
Regular Play Series $40    x      FlexPasses
Senior Play Series (62+) $30    x      FlexPasses

Grand Total    $

Method of Payment

Will send check to Community Theatre
Visa
Master Card
Debit Card

Type name as it appears on card:

Card No. Exp.

V Code (3 digits on back of card)