Albert Einstein High School S

ALBERT EINSTEIN HIGH SCHOOL S.T.A.G.E.

11135 NEWPORT MILL RD.

KENSINGTON, MD 20895

301-962-1028 fax: 301-962-1016 e-mail:

S.T.A.G.E. HANDS

Sponsorship Program

Registration Form FALL 2015 – NOISES OFF/AUDIENCE

Please Print

Name(s) ______

Address ______

City/State/Zip______

Home Phone ______

E-mail ______

Parent or Friend of ______

Contribution Level Desired:

Status Min. Amount

_____ PATRON $10 – 49.99 Amount Contributed: $______

_____ SPONSOR $50.00 – 99.99 Amount Contributed: $______( 2 free passes)

_____ DONOR $100.00 -149.99 Amount Contributed: $______(4 free passes & shirt)

_____ BENEFACTOR $150.00+ Amount Contributed: $______(6 free passes & 2 shirts or hoodie)

(Benefactors who donate $250 or more will receive 8 free passes)

How would you like your name(s) listed in programs?

ex. John and Mary Smith, Mr. and Mrs. John Smith, The Smith Family, etc.

List name(s) as:______

Signature: ______

This contribution is for the FALL 2015 season (NOISES OFF and AUDIENCE) To be included in the program for the fall play, please send your contribution by October 30, 2015.

Please send completed form, along with check payable to Albert Einstein High School, to:

Albert Einstein High School S.T.A.G.E.

Attn Peter Smeallie, Theatre Director

11135 Newport Mill Road

Kensington, MD 20895

Contributions may also be made through our box office partner – www.showtix4u.com

(Contribution window opens approximately October 15, 2015)