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Join Cocoon Friends - FormPlease print this page, fill out the form, and return it to us at: Cocoon Theatre, Inc.
Please make your check out to Cocoon Theatre.
Return to Become a Cocoon Friend! _____ Student/Senior, $25/year (Receive mailings, invitation to annual pot luck)_____ Individual, $50/year (same as above) _____ Family, $100/year (same as above) _____ Contributor, $250/year (Receive mailings, invitation to pot luck, and one special event) _____ Sustainer, $500/year (Receive all of the above plus invitation to all special events) _____ Patron, $1000/year (Receive all of the above plus two tickets to two 2004 productions) _____ Benefactor, $5000/year (Receive all of the above plus two tickets to all 2004 productions) _____ Yes, I would like to make a donation to the Cocoon Theatre Scolarship Fund in the amount of: _________ _____ Yes, I would like to make a one-time donation to Cocoon Theatre in the amount of: _________ _____ Yes, I would like to be placed on the general mailing list. Name: ________________________________________ Street Address/ P.O. Box: ______________________________________________________ City, State, Zip: ___________________________________________________________ Phone(s): ____________________ ____________________ E-mail: _____________________ |
6384 Mill Street (Rt. 9), Rhinebeck, NY 12572
(845) 876-6470