This form is laid out to print on one sheet of letter paper.

Nanaimo Theatre Group — Membership Form

Please print clearly. You can also complete your membership online at dev.ntgexec.ca/members

Date

About you

First name
Last name
Birth year
Email
Preferred phone
Street address
City
Province
Postal code

Additional information — Experience, Training, Special Skills, etc.

Areas of interest

Acting Committees Concession Costume - Construction Costume - Design Dance Directing Entertainment Front of House - Manager Front of House - Usher Hair Lighting - Design Lighting - Operator Make-up Marketing Music - Instrument Music - Singing Music - Directing Play Writing Producing Projections Properties Special Effects Social Events Set - Construction Set - Design Set - Dressing Set - Painting Sound - Design Sound - Operator Stage Crew Stage Manager Stage Manager Assistant
If Music - Instrument: which instrument(s) do you play?

Family memberships only: additional family members

Name Email Birth year Votes

A family membership has up to 2 voting adults: tick Votes for them (you may tick yourself here: ☐ I vote). Everyone listed is invited to complete their own interests and permissions, online or on their own copy of this form.

Agreements and permissions

I understand and agree that in accordance with our club constitution and policies, no member of NTG will be paid for involvement in club activities. Please check box below.

I agree to the Constitution and Policies - No Payment

I agree to the Membership Expectations document.

I agree to the Membership Expectations Document

By becoming a member I give NTG permission to contact me by both email and/or phone.

I agree to the terms & conditions - Contact

I grant permission to NTG to use my name and/or picture online on both social media sites and the NTG website and/or NTG related publications. Please select one option below.

I agree to the above publications. I DO NOT agree to the above publications.
Signature
Date
Office use Payment received ☐ ThunderTix order # ____________ Entered by ____________