REGINA OPERA GUILD
MEMBERSHIP APPLICATION

Name  

Street Address  

Street Address 2  

City     State     Zip Code  

Daytime Phone: Area Code     Number  

Evening Phone: Area Code     Number  

E-mail Address  

Membership Type (fees subject to change):

Gold Curtain Single ($45)     Gold Curtain Couple ($55)

Diamond Horseshoe Single ($60)     Diamond Horseshoe Couple ($75)

Please check this box if this is a renewal:  

Regina Opera Company is a non-profit organization.
Payment in excess of $12.25 for single membership and $24.50 for couple membership is tax-deductible.