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ANNUAL FUND DONATION FORM |
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To make a donation to the 2003 Annual Fund, simply complete the following form, print it and send it along with your contribution to:
Albany Institute of History & Art External Relations Division 125 Washington Avenue Albany, NY 12210
For questions or more information, contact the External Relations Division at 518-463-4478. |
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YES! I/We would like to make a donation to the 2003 Annual Fund to continue to support the Albany Institute's schedule of exhibitions, public programs and educational services.
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| Enclosed is my/our Annual Fund contribution of: | ||||||||||||
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Name (s): _______________________________________ Please indicate name (s) as you wish to be listed. |
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| Address:________________________________________ | ||||||||||||
| _________________________________________ | ||||||||||||
| _________________________________________ | ||||||||||||
| City: _____________________ State: ____ Zip:________ | ||||||||||||
| Daytime Phone: _________________________ | ||||||||||||
| Evening Phone: __________________________ | ||||||||||||
| Email address:___________________________ | ||||||||||||
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q Enclosed is a check or money order in the amount of $_________ made payable to: Albany Institute of History & Art |
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OR |
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| q Please charge the amount of $__________ to: | ||||||||||||
| q Visa | q MasterCard | |||||||||||
| q Discover | q American Express | |||||||||||
| Card Number: | _______________________________________ | |||||||||||
| Expiration Date: | _______________________________________ | |||||||||||
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Signature: |
_______________________________________ | |||||||||||
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My employer __________________ will match my gift.
q I have enclosed the matching gift form. |
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To make a gift of stock or charge by
phone, please call the Business Office at 518-463-4478. Please note this contribution is not for museum membership. Your gift is tax-deductible to the extent allowed by law. |
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