Enclosed is my donation for:

$ ________ $ 25 - $ 49 General Support Level $ ________ $ 50 - $ 99 Intern Circle $ ________ $ 100 - $ 224 Designer Circle $ ________ $ 225 - $ 349 Playwright Circle $ ________ $ 350 - $ 999 Actor Circle $ ________ $ 1000 + Director Circle $ ________ Other Amount (Every Donation Helps!)

Membership Information

________	My gift will be matched by my employer, and I have enclosed or will forward the necessary forms (from my Human Resources Department).
________	I prefer not to receive any CTC benefits, so the full amount of my donation is tax deductible.
________	I wish to donate stocks or other securities to California Theatre Center.  Please contact me with instructions for this type of donation.
________	I wish to donate my vehicle to California Theatre Center. Please contact me with instructions for this type of donation.

Name ____________________________________________________________________

Address ___________________________________________________________________

City __________________________________  State ________  Zip __________________

Telephone (_____) ______-_______________

Email Address ______________________________________________________________

____ Check Enclosed            ____ Mastercard            ____ VISA

                                   Name on Card ____________________________________________
                                   Account No. _________________________ Exp. Date ___________
                                  CVV2 Code___________(on the back of the card, the last three numbers printed across signature line)

                                   ____  I prefer to charge by phone and will call 408-245-2978 or 245-2979.