I want to invest for the future.

Name ________________________________________________________________________________________________

Address ______________________________________________________________________________________________

City _________________________ Province ____________ Postal Code ________________________________________

Home phone: (       ) ____________________ Work: (       ) ____________________________________________________

E-mail ________________________________________________________________________________________________

O Writing Membership: $55
O Supporting Membership: $45
O Student Membership: $20
O Please accept my donation of $ ________________

O Cheque enclosed
O Bill my Visa / Mastercard / Amex, number: _________________________ Exp. date __________________

For in honour / memory donation only. Please check one and complete

O In honour of
O In memory of
______________________________________________________________________________________________________

Special message to honouree:
______________________________________________________________________________________________________


Address to send personalized letter:
______________________________________________________________________________________________________

______________________________________________________________________________________________________

Playwrights’ Workshop Montréal

5337 Blvd. St-Laurent, Suite 240
Montréal, QC H2T 1S5
Tel: (514) 843-3685
Fax: (514) 843-9384
www.playwrights.ca

Playwrights’ Workshop is a registered Canadian Charity (no. 11909 4738 RR 0001). Thanks for your support.