Membership in Coloma Players, Inc.

Name________________________________________________

Address______________________________________________

City________________________State________Zip___________

E-Mail______________________________________

Phone___________________________

Yearly Membership $12.00_____________
Become a Lifetime Patron with your $100.00 membership_____________
Additional Donation $_____________
Total $_____________

Check #________________ Date______________

*Make check payable to and mail with this form to:
W13190 Cypress Lane
Coloma, WI 54930

Your membership and donations are fully tax deductible and you will receive an acknowledgment of your support.

Membership includes:
> Receive our informative newsletter
> Two $1.00 discount coupons for any performance
> You help to support our High School Scholarship Program
> You help to upgrade our technical equipment
> Lifetime Membership includes two discount coupons mailed to you each year and your choice of one of our very neat Coloma Players items – hats, mugs, t-shirts, and tote bags