Subscription Order Form


NAME: _________________________________________________________________

ADDRESS: ______________________________________________________________

________________________________________________________________________

CITY: ________________________________ STATE: ______ ZIP: ________________

PHONE: ____________________________ E-MAIL: ____________________________

Type of Subscription How Many?  
Cost
FlexPass 6 (6 tickets) __________ x $65 each = __________
FlexPass 3 (3 tickets) __________ x $35 each = __________
TOTAL SUBSCRIPTION COST     __________
Additional Tax-Deductible Donation     __________
TOTAL AMOUNT ENCLOSED     __________

Print this page and fill out the form.
Make checks payable to: Prospect Theater Co.
Mail form and payment to:

Prospect Theater Co.
345 East 65th St. #4C
New York, NY 10021