Metropolitan Symphony OrchestrA Donation Form
The Metropolitan Symphony Orchestral Association is a non-profit, tax-exempt 501(c)(3)
organization, and contributions are tax-deductible to the extent of the law. Your generous financial
participation is greatly appreciated!
This form is provided so you may print out this page and mail in your payment with your contact information. Please print this form, fill in the blanks and send your payment to us by mail. Make a copy of your print out of this page for your records.
| ____ |
$2,000+ |
– Conductor's Circle |
| ____ |
$1,000-$1,999 |
– Guarantor |
| ____ |
$500-$999 |
– Sponsor |
| ____ |
$200-$499 |
– Benefactor |
| ____ |
$100-$199 |
– Patron |
| ____ |
$50-$99 |
– Friend |
| ____ |
Under $50 |
– Supporter |
Name(s): _____________________________________
(as you wish it to appear in our programs)
Address: _________________________________________________
City: ______________________ State: ________ Zip: _____________
Phone: ____________________ Evening: ______________________
Attributed To: _____________________________________________
(if this gift is in memory or on behalf of someone, please fill in here)
You may enclose a check or provide your credit card information below:
| Card Holder: |
_______________________ (as it appears on your credit card) |
| Card Type: |
VISA Master Card AMEX (circle credit card type) |
| Card Number: |
________________________________ |
| Exp. Date: |
________ |
| Security Code: |
________ |
| Amount: |
$ ____________ |
| Please make checks payable to: |
The Metropolitan Symphony Orchestral Association |
Please send this form
and your payment to: |
The Metropolitan Symphony Orchestra
P.O. Box 581213
Minneapolis, MN 55458-1213 |
For more information please contact us at: (651) 645-4283 or info@msoa.net |
