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STOURBRIDGE THEATRE COMPANY

APPLICATION FORM

Name: 
Address: 
 
Post Code: 

Telephone - Evenings:                                       Daytime:

e-mail address: 

You are able to become either a Member or a Patron, or go onto the Mailing List. 

Membership for a year (or remainder of a year) costs: 

Member: £15.00     Patron: £30.00     Junior £4.00     Mailing List: No Charge 

The Membership Year runs from 1st April to 31st March. 

* I WOULD LIKE TO BECOME A MEMBER/PATRON/BOTH 

* I WOULD LIKE TO GO ON TO THE MAILING LIST 

If you are planning to become a Member, what are your particular interests? (please tick) 

Acting   Scenery   Playreading  
Front of House    Producing   Backstage  
Publicity   Social Events   Other  


Is this your first venture into drama? If not, what previous experience have you had? 


Signed: 

Date: 

Please make cheques payable to: Stourbridge Theatre Company. 
Send your cheque, and a completed print-off of this page to the Secretary:

Wendy Packer
2 Cranbourne Road
Stourbridge
DY8 1QZ
07751 375437