Revive The Regent Theatre Mudgee Inc. Membership Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for deciding to join Revive The Regent Mudgee Theatre Inc. Membership supports the work of our organisation and helps us preserve the heritage of our beloved theatre in Mudgee’s main street.

Become a member today and support our mission to Revive The Regent and help ensure its use as a theatre for future generations. As a member, you will have received our quarterly newsletter, special monthly member updates and early invitations to events.

If you are already one of our Revive The Regent members, you can Renew your membership online here!

* Please note that your membership may take 2-3 weeks to process, payment information will be sent via an invoice emailed to you.

Email *

First Name *

Last Name *

Mailing Address (Please include State and Postcode) *

Mobile Phone *

Home Phone *

Membership Type *

Full Price Member - $50

Concession Price Member - $35

Student Price Member - $20

Local National Trust Member - $25

If you would like to sign up on behalf of others, please provide their names and email below:

Have you paid your membership fee? *

Yes

No (Please email me instructions on how to pay)

Do you wish for your membership to remain anonymous to public recognition? *

Yes

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms