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NEW BEDFORD FESTIVAL THEATRE SUPPORT ENROLLMENT FORM
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New Renewal:   Yes      No

Yes, I would like to support the efforts of New Bedford Festival Theatre.


Amount of Donation  $________________


Please print name as you would like it to appear in the program book:

________________________________________________________


Name:  _________________________________


Address:  ______________________________


City/Town:  ____________________________


State/Zip:  ____________________________


Phone:  ________________________________



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IF USING CREDIT CARD:
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Name on Card: __________________________________


Type of Card:  Amex      Discover      M/C     Visa


Card # ________________________________________


Exp. Date: ________________




Signature: _____________________________________