Double or Triple Your Donation With Your Employer’s Matching Gift Program

It’s simple! Just remember to include your matching gift form with your membership enrollment.
For more information, call the Greenwich Arts Council office at 203.862.6750.

Please Print Your Name As You Wish It To Be Listed

Name: ____________________________________________________

Address: __________________________________________________

__________________________________________________________

City: _____________________________________________________

State: ____________________________________________________

Zip: ______________________________________________________

Telephone: ________________________________________________

Email: ____________________________________________________

Employer: _________________________________________________

Fill in your desired membership in its corresponding oval below:

O Individual: $35                    O Senior/Student: $25           O Family/Dual: $50

O Friend: $100 + above          O Patron: $1000+

Please Make Check Payable To GAC

Please Charge To My:  O Visa          O MasterCard          O Amex

Credit Card #: ____________________________________________

Expires: ____________________________________________

Signature: ____________________________________________

O Employer Matching Gift Form Is Enclosed

Membership Dues Are Tax Deductible And Greatly Appreciated!

 

Please also indicate if you would like to volunteer:      O I Would Like To Volunteer