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MEMBERSHIP

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Last Name or Organization Name*

First Name or Contact Name*

Street Address*

(include P.O. Box, Apt #, etc.)

City*

Province*

Postal Code*

Home Phone*

Work Phone*

Fax

Cell Phone/Pager #

Preferred Method of Contact*

Regular Mail
Email

Email Address*

AFFILIATION

CAEA
IATSE
ACTRA
APN

Other

MEMBERSHIP CLASSIFICATION*

Group A = annual operation budget under $10,000/year
Group B = annual operation budget under $100,000/year
Group C = annual operation budget over $100,000/year

For INDIVIDUAL Memberships

I AM*

*

Add a general membership with Alberta Playwrights' Network

+ $15 for 1 year
+ $30 for 2 years

For GROUP Memberships Only

THEATRE CLASSIFICATION*

Professional / Union
Professional / Non-Union
Community Theatre
Educational Institute

SECOND CONTACT (also has library privileges)

Name

FirstLast

Street Address

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City

Province

Postal Code

Home Phone

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Email Address

Please specify how Theatre Alberta can use your contact information

You may release any of the above contact information with no prior consent.
You may release my phone number(s) and e-mail addresses only with no prior consent.
You may release my e-mail address(es) only with no prior consent.
You may release my contact information only with prior consent.
You may not at any time release my contact information.

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PAY LIBRARY FINES

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DONATION

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Charitable Registration Number 106693039 RR0001

Total

$ 0.00 CAD

Phone:	780-422-8162
Toll free in Alberta:	1-888-422-8160
Fax:	780-422-2663 (Attention Theatre Alberta)
Email:	theatreab@theatrealberta.com
Library:	library@theatrealberta.com