Chair Patron Order Form
 
Thank you for your sponsorship to become a Chair Patron of the Seminole Cultural Arts Theatre. Before filling out this form, make sure you have your receipt ID # from your receipt payment confirmation. This receipt number should have arrived via eMail right after completing step 1 of your Chair Patron registration. Each engraved plaque may include up to three line of copy, not to exceed 36 characters per line including the spaces between words.
 
 
Name
 
 
 
Street Address
 
City
 
State
 
Zip Code
 
Telephone
 
eMail
 
Receipt ID #
 
Engraved Line 1
 
Engraved Line 2
 
Engraved Line 3