| Name: | _______________________________ |
| Company: | _______________________________ |
___________________
| Address: | _______________________________ |
| Phone: | (___)___________ |
| I have enclosed my check made payable to Castaways Repertory Theatre for the following donation |
| __$50+ Friend . __$100+ Supporter . __$150+ Patron . __$250+ Angel |
| $____Other |
| I can suggest the following source for an in-kind donation if they are needed for future productions. |
| Company: | _______________________________ |
| Products/Service: | _______________________________ |