Producers’ Circle Enrollment Form
Members of the Producers’ Circle, Broadway Rose’s monthly giving program, play a special
role in sustaining our artistic and educational programs. As a member of the Producers’
Circle, you choose to make an annual pledge of any amount, which is paid in monthly
installments over the course of the year. Your ongoing support helps ensure that Broadway
Rose can continue producing luminous musical theatre for years to come.
Things to know:
• Monthly payments may be made by check or credit card. Credit cards are charged
around the 15th of each month.
• We will send you a tax letter in December with a total of the year’s contributions.
• Your membership renews automatically each year.
• You may cancel your membership or change your giving level at any time.
• You’ll be eligible to receive donor benefits based on your annual giving level (plus any
additional contributions you make, if applicable).
Name(s): _____________________________________________________________________
Check here if you wish to remain anonymous in the program.
Address: ______________________________________________________________________
Phone number(s): ______________________________________________________________
Email address: _________________________________________________________________
I will make my monthly payment by check.
I will make my monthly payment with the credit card listed below.
Credit card: Visa MasterCard Discover American Express
Name on credit card:____________________________________________________________
Credit card number:_______________________________________ Expiration date: _______
Amount per month: $__________________
Signature:_____________________________________________________________________
To enroll, complete this form and submit it to Broadway Rose at the address listed below.
Have questions or need to update your information?
Contact our Development Manager at 503.906.2376 or [email protected].
Broadway Rose Theatre Company • P.O. Box 231004 • Tigard, Oregon 97281 • www.broadwayrose.org
Box Office: 503.620.5262 • Admin: 503.603.9862 • Fax: 503.670.8512