Portage Community Theatre             

Name:_________________________________________
Address:_______________________________________
City:__________________ State:_________ Zip:_______
Cell:__________________ Phone:___________________
Email:__________________________________________

Please list the last three productions you have been involved in:
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Role(s) you are auditioning for:_________________________
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Will you accept any role? (Please be honest)
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Please list any scheduling conflicts you may have:___________
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