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2. Full Name*
4. Phone Number*
5. Email Address*
7. May we contact you via email? (you may opt out at any time)

   1. Yes
   2. No

   Please check one - if you do not wish to receive an email, please provide the best telephone number to reach you at.
9. Center Stage Society Level of Interest:

   Tell us which level(s) you are interested in joining

   1. Friends ($150+)
   2. Artistic Director ($450+)
   3. Director ($750+)
   4. Producer ($1,200+)
   5. Conductor ($2,500+)
   6. Executive Producer ($5,000+)
   7. Benefactor ($10,000+)
10. 501 Club Level of Interest

    Tell us which level(s) you are interested in joining:

    1. Partner ($150+)
    2. Promoter ($300+)
    3. Creative ($500+)
    4. Artist ($1,000+)
12. Comments/Questions
    Please tell us what aspects of the arts you are interested in and which benefits you are interested in receiving.
14. 
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21. 1. Receive an email copy of this form.
22. Email address

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23. Submit

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