2009 – 2010 Auxiliary Council Application Form Biographical Information: Name:
Employer: ___________________________
Address:
Title:
City, State Zip:
Address:
E-Mail:
City, State Zip:
Phone:
E-mail:
Spouse/Partner:
Phone:
Please send all Steppenwolf correspondence to my home/business (please circle one). Membership: ______ I WOULD LIKE TO APPLY FOR AN AUXILIARY COUNCIL GOVERNOR POSITION $250 tax-deductible contribution. Please note that checks will be held, and credit cards will not be charged, until after formal nomination and subsequent election by the Governors.
______ I WOULD LIKE TO BECOME AN AUXILIARY COUNCIL ASSOCIATE. $75 per person or $135 per couple tax-deductible contribution. Subscription (optional): Take Advantage of the Auxiliary half-price Wednesday night 5-play season subscription AND Steppenwolf for Young Adults 2-play add-on.
__________
I would like to purchase _________ season subscriptions at $130 each.
__________
I would like to purchase _________ SYA subscriptions at $40 each.
Payment: ___ Please charge me $ ___________ Credit Card # __________________________________________ Exp. Date _________ ___
I have enclosed a Check Made Payable to Steppenwolf Theatre in the amount of $_________.
Committee Sign-Up (optional): SPECIAL EVENTS COMMITTEE: Organizes all of the elements of the annual Auxiliary Council fundraiser, The
Red or White Ball, including invitations, sponsorship, entertainment, marketing and volunteers. SYA COMMITTEE: Works with the Steppenwolf Young Adults Liaisons who are responsible for educating the group on Steppenwolf’s education programs. Committee members also have the opportunity to volunteer during Young Adult performances.
Employment History: Education: Other not-for-profit affiliations, awards, hobbies: How did you hear about Steppenwolf’s Auxiliary Council?
Steppenwolf Theatre Auxiliary Council 758 West North Avenue, Chicago, IL 60610 • Fax: 312-335-0808 • alebedoff@steppenwolf.org Please contact Annie Lebedoff, Individual Giving Associate, with any questions you may have at 312-654-5681.