The Phil's Annual Fund Donation Form

Fort Wayne Philharmonic Annual FundNAME:

LIST HOW YOU WOULD LIKE TO BE RECOGNIZED IN THE PHIL’S PROGRAM BOOK, PRELUDE:

ADDRESS:

CITY: STATE: ZIP:

PHONE:

EMAIL:

I AM ELIGIBLE FOR A MATCHING GIFT FROM MY EMPLOYER:

SPECIAL COMMENTS:

Gifts to the Fort Wayne Philharmonic are tax-deductible as allowed by law.

Check here if you DO NOT want the benefits of your giving level that carry monetary value. (Your contribution will be fully tax-deductible.)

Check here if you DO NOT want to be recognized in donor lists. (Your gift will be anonymous.)

Check here if you have included The Phil in your estate plans.

Gift of securities - Please call the Finance Office at 260.481.0785

All other inquiries - Please call the Development Office at 260.481.0775

I WILL PAY NOW

THIS IS A PLEDGE. REMIND ME OF MY PLEDGE IN ___ / ___ (MONTH/YEAR)

BILL ME FOR (#) ___ MONTHLY INSTALLMENTS OF $______ BEGINNING ___ / ___ (MONTH/YEAR)

CHECK: PAYABLE TO FORT WAYNE PHILHARMONIC

VISA MASTERCARD

AMEX DISCOVER

ACCOUNT NUMBER:

EXP. DATE: ___ / ___ (MONTH/YEAR)

Please Send All Gifts To:

Fort Wayne Philharmonic4901 Fuller DriveFort Wayne, Indiana 46835