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Support Seniors Making Art
With a tax-deductible donation.

 Donor Classification:
 Chihuly Circle ($10.000 +)
 Benefactor ($3,500 +)
 Sponsor ($2,500-$3,499)
 Patron ($1,000-$2,499)
 Friend ($500-$999)
 Contributor ($15-$499)

  I will donate: 
  (ex. $100.00)
In memory of:
 Credit Card Information:
Visa            MasterCard
  Name as it appears on the card:
Credit Card #:
CC Exp Date (ex. 10/04):

 Employer Information:
  My employer will match my donation.
 My Employer's Name is:
Employer's Phone:
   I would like to volunteer!
   I will designate my gift through the United Way.
   I do not wish my gift be publicly acknowledged.

 Donor's Information:

Your Full Name:
Mailing Address:
Apt., Suite, Unit:
City:
State:
ZIP:
E-mail Address:
Day Phone:
Evening Phone:

 *Donors receive an invitation to the appreciation event at Chihuly's Boathouse.
 *Dependant upon Boathouse availability.

 Seniors Making Art is a recongnized 501(c)(3) non-profit organization.
 Thank you for your support!
        

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