Date______________

5509 Main Street, Flowery Branch, GA  30542 Phone 678-357-7359

This e-mail address is being protected from spambots. You need JavaScript enabled to view it.   www.fifthrowcenter.com

___Platinum Member  $500

Receives 4 Tickets to every production for 12 months or 16 total tickets,

Full Page ad in 2 playbills of your choice and recognition in all other playbills.

Please send us your ad.

___ Gold Member  $300

Receives 2 Tickets to every production for 12 months or 8 total tickets,

½ Page ad in one playbill of your choice and recognition in all other playbills.

Please send us your ad.

___ Silver Member  $200

Receives 1 Ticket to each production for 12 months or 4 total tickets,

a two-line ad in one playbill of your choice and recognition in all other playbills.

Please send us your ad.

___ Bronze Member  $100

Receives 4 Individual tickets to any show within 12 months of join date.

___ Copper Member  $35

Receives 2 Individual Tickets to any show within 12 months of join date.

Name   __________________________ E-mail________________________

Address  _______________________________________________________   

                      Street                                        City                      State              Zip

Phone_________________    Company Name ________________________

Please make checks payable to:  Fifth Row Center

For Office Use Only:

Ck/Cash _______________________         Pay Date____________________________