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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 ____________________________ Mail to: TANYS, PO Box 4143, Rome, NY 13442 Important - Please allow 10-14 days for membership processing 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 - up to 4 family members) $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 # _____ For Office Use Rcvd ______ Check # _____ ✓ Mail to: TANYS, PO Box 4143, Rome, NY 13442 Please print clearly Please print clearly Basic (if paid by 3/31) q $75 Basic (if paid by 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 2023 and help TANYS reduce our costs for mailing renewal notices. ✓ out the levels of membership and see what fits for you and/or your organization! n e w N o w F o r 2 0 2 3 !

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