Southampton Village First Responders and Active Military/ Veterans Membership Application Form
SOUTHAMPTON PLAYHOUSE
APPLICATION PROCESS
To apply, please provide the requested information below. Once received, we will process your Discount Card and send a confirmation directly to your email. If you prefer not to submit your information through this form, you may email it to BOXOFFICE@SOUTHAMPTONPLAYHOUSE.COM or bring it in person to the box office. Applications may take up to one week to process. Thank you for being a member of our community. At this time, only First Responders who work in the Village of Southampton Are Eligible.
Application Date
*
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Month
-
Day
Year
Date
Please Choose One
*
Please Select
Southampton Village First Responder
Active Military
Military Vet
Military Active/Vet Spouse
NAME
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Upload Proof: First Responders, Active Military, and Veterans
Membership ID for the Southampton Village EMT, Police Department, Fire Department, Rescue Squad or Similar First Responder Organization.
Please upload the screenshot below.
*
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if you wish to send to us directly please do to accounting@southamptonplayhouse.com
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