Name  
Address  
City
State
Zip
Phone
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Donor Level

Enter amount in box.

Angel: $1000 and up
Producer:$500-999
Director: $250-499
Star:      $100-249
Other

Please print form and mail a check to:

Henlopen Theater Project
PO PO Box 606, Rehoboth Beach, DE 19971
or
submit form below and e-mail credit card info.