Alternate Ad Submission Form

Business Contact Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

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Would you like to use the same art from your ad last season? (If applies.)

Yes

Advertiser agrees to indemnify Music Theatre of Connecticut from any legal dispute arising from this ad. Music Theatre of Connecticut will not share any credit card information and has permission to contact me should there be any issues with payment. Upon submission, the provided credit card will be charged in 1-5 business days. *

I agree