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TANYS MEMBERSHIP FORM ORGANIZATIONAL - January thru December Year ______ Organization________________________________________________________________ Mailing Address _____________________ Contact Person ______________________ City _______________ St. ___ Zip _____ Mailing Address ______________________ Org. Phone (___)_____________________ City _______________ St___ Zip ________ Division: q Secondary q Community E-mail _______________________________ q College q Children’s Contact Phone (___)___________________ Org. E-mail _________________________ LEVEL (check one) Website ____________________________ If your company does not have its own website Producer q $100 we will build you a web page on our site. Star q $150 E-mail; webmaster@tanys.org Mail to: TANYS, PO Box 4143, Rome, NY 13442 Membership Amount ___________________ For Office Use Only Rcvd ______ Check # ______ TANYS MEMBERSHIP FORM INDIVIDUAL – January thru December Year________ Name______________________________________ Phone (___)__________________ Mailing address ______________________________ County _____________________ City ______________________ St. _____ Zip _________ LEVEL (check one) E-mail __________________________________________ q Current NYSTEA member $20 Theatre Group Affiliation __________________________ q Student $20 q Crew (Individual) $30 Please consider adding a donation to TANYS’ q Cast (Household- 2 adult/2 children) $75 ongoing support of academic and community theatres q Producer $125 q Star $250 q Angel $500 in New York State. All donations are tax-deductible. Membership Amount ____________ Donation + ____________ Total Amount Enclosed ____________ For Office Use Rcvd ______ Check # _____ ✓ Mail to: TANYS, PO Box 4143, Rome, NY 13442 Please print clearly Please print clearly IMPORTANT -- Please allow 10-14 days for membership processing. Basic (if paid by 3/31) q $75 Basic (if paid between 4/1-6/30) q $85 Basic (if paid after 7/1) q $95 Producer q $125 Star q $175 Angel q $275 & up TANYS membership year runs from January thru December. Renew NOW for 2019 & save TANYS the cost of sending you a renewal notice. ✓ out the levels of membership and see what fits for you and/or your organization!

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