| Please make checks payable to: Nashua Community Concert Association | ||
| and mail with this application form to: Nashua Community Concert Association Mary E. Sayre, Membership Secretary PO Box 1563, Nashua, NH 03061–1563 |
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| Adult Memberships: $45.00 each | $__________ | |
| Student Memberships: $15.00 each | $__________ | |
| full-time, age 22 or younger | ||
| Tax deductible Contribution: | $__________ | |
| TOTAL | $__________ | |
| E-Mail Address:______________________________________________ | ||
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| Name:___________________________________ Telephone:_____________ | ||
| Street Address:_______________________________________________ | ||
| City/State/Zip:_______________________________ | ||
| Ticket Holder Name(s) Please circle for each to indicate NEW or RENEWAL and ADULT or STUDENT | ||
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NEW or RENEWAL ADULT or STUDENT ___________________________________________________________ |
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NEW or RENEWAL ADULT or STUDENT ___________________________________________________________ |
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NEW or RENEWAL ADULT or STUDENT ___________________________________________________________ |
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NEW or RENEWAL ADULT or STUDENT ___________________________________________________________ |
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NEW or RENEWAL ADULT or STUDENT ___________________________________________________________ |
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NEW or RENEWAL ADULT or STUDENT ___________________________________________________________ |
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Worker: ___________________________________________
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| Your check is your receipt. Membership cards will be mailed in the fall. | ||