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
Fifth Row Center is a 501(c)3 non-profit organization, so any contribution is tax deductible.
For Office Use Only:
Ck/Cash _______________________ Pay Date____________________________



