Outpost In The Burbs - Membership Form

2008 / 2009 Outpost Membership Program

Membership Level (please circle one): Platinum ($250) Gold ($120) Silver ($60)

Name:	_____________________________________________________________

Address:	_____________________________________________________________

	_____________________________________________________________

Email:	_____________________________________________________________

Phone:	_____________________________________________________________

Send your check or money order to:	Outpost in the Burbs
	40 South Fullerton Ave
	Montclair, NJ 07042
	Attn: Membership Department

Platinum Member - $250/year

Annual subscription to the Outpost Reader
Free refreshments for 2 at all concerts attended
Advanced sale price for concert tickets at all times (including at the door)
2 reserved seats (up front) to concerts, with your paid admission
2 complimentary tickets to a concert of your choice (subject to availability)

Gold Member - $120/year

Annual subscription to the Outpost Reader
Free coffee or water at all concerts attended
Advanced sale price for concert tickets at all times (including at the door)
2 reserved seats (up front) to concerts, with your paid admission

Silver Member - $60/year

Annual subscription to the Outpost Reader
Free coffee or water at all concerts attended
Advanced sale price for concert tickets at all times (including at the door)