NMOB MEMBERSHIP DRIVE FOR 2004

Please fill out and return this form to:

          NMOB, P.O. BOX 565,

           New Paltz, NY 12561

Name:_____________________________________

Mailing address:____________________________

___________________________________________

___________________________________________

Email address:_______________________________

Phone # (day):_______________________________

Phone #(evening)____________________________

CHOOSE ONE OF THE FOLLOWING

_____BENEFACTOR ($100 PER YEAR)

_____SPONSER($50.00 PER YEAR)

_____PATRON ($25.00 PER YEAR)

_____MEMBERSHIP($10 PER YEAR)

_____FRIENDS (NO COST-NOTIFICATION OF PERFORMANCES ONLY)

We are looking for active members to attend meetings and work on productions.

(In order to stay on our mailing list, we will need this information returned by January 31, 2004)