Musical Theatre West Donor/pledge Form printable pdf download

Musical Theatre West Donor/pledge Form

DONOR/PLEDGE FORM

Donor name(s)

Program Listing

Address

City/State/Zip

Phone

Fax

E-mail

By signing below, I/we are committing to the following donation/pledge to Musical Theatre West:

Amount:

To Be Used For:

___ General Fund

___ Education/Outreach

____Special Event __________________

(Check one)

___Production:

____ Other:

Notes:

___________________________

______________________________________________________________________________________________

PAYMENT INSTRUCTIONS

___ I am fulfilling the entire pledge at this time.

___I will pay the entire pledge on or before

(please send me an invoice two weeks prior).

___I would like to be billed in

installments of $

. ___Weekly ___Monthly

___Beginning on

___ Check enclosed (payable to Musical Theatre West)

___Please charge my:

___ Visa

____MasterCard

_____American Express

____ Discover

Card Number

Expires

CVV Code

____ Other method of payment

CONFIRMATION

Signature

Date

Musical Theatre West is a California 501(c)3 Non-Profit Corporation, Federal Tax ID 95-6100108.

All donations all tax-deductible for the full amount less the value of any goods and/or services received.

For more information, please call (562) 856-1999 x229

THANK YOU FOR YOUR SUPPORT!

Musical Theatre West Donor/pledge Form

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