Backstage Theatre - Be a Donor

Backstage Theatre Donation Form

121 South Ridge Street | PO Box 297 | Breckenridge CO 80424
(970) 453-0199 | (970) 453-4382 FAX
www.backstagetheatre.org | info@backstagetheatre.org

Please indicate your level of support: $__________

	Amount	Donation Appreciation Items
PRODUCER	$2,500+	Six (6) Gold Passes valid for admission to any Champagne Evening or any regular performance during the 2007-08 season.
STAR	$1,000+	Two (2) Gold Passes valid for admission to any Champagne Evening or any regular performance during the 2007-08 season.
LEAD	$500+	Six (6) tickets to any Champagne Evening or any regular performance of the 2007-08 season.
SUPPORTING	$250+	Two (2) tickets to any Champagne Evening or any regular performance of the 2007-08 season.
CAMEO	$150+	Four (4) tickets to any regular performance of the 2007-08 season.
CHORUS	$75+	Two (2) tickets to any regular performance of the 2007-08 season.
UNDERSTUDY	$1+	Our undying gratitude!

Name _______________________________________________________________________

Address _____________________________________________________________________

City/State/Zip Code ____________________________________________________________

Phone _______________________________________________________________________

Email Address _________________________________________________________________

__ I do not wish to receive goods (i.e. tickets, Gold Passes) in exchange for my donation.
__ Please send me more information on upcoming shows and events.
__ I am interested in show sponsorship opportunities.

Method of Payment: (Please circle one)

Check Visa MasterCard American Express Portfolio Donation

Credit Card Number ___________________________________________________________

Expiration date __________________________ Today's Date __________________________

Signature ___________________________________________________________________

Backstage Theatre is recognized as a 501(c)(3) Non-profit organization by the IRS. The deductibility of your donation for income tax purposes is reduced by the value of goods received. Gold Pass is valued at $212, Champagne Evening ticket $25, Regular-priced ticket $18.