OC Theatre Guild Registration
Name
*
First Name
Last Name
E-mail
*
Phone Number:
*
-
Area Code
Phone Number
Address:
*
Street Address
Street Address Line 2
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Please Select
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Organization or Producer - $250
(
$
250.00
for each
year
)
Individual - $50
(
$
50.00
for each
year
)
Total
$
0.00
Email
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Organization Name:
Brief organization description. (100 words or less.)
Artist Type:
Theatre Artist
Theatre Educator
Theatre Patron
Playwright
Actor
Director
Music Director
Choreographer
Scenic Designer
Costume Designer
Light Designer
Sound Designer
Stage Manager
Dramaturg
Technician
Other
Website:
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