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Name
___________________________________
(Please
PRINT name/business as you would like it to appear in our program.)
Address
_________________________________
City/State/Zip _____________________________
Phone (day)
______________________________
(eve)____________________________________
E-mail ___________________________________
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ð My
phone number/address has recently changed.
ð My
employer will match my gift.
Please print employer's name and address:
___________________________________
___________________________________
___________________________________
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ð I
wish my gift to remain anonymous.
ð This
gift is in Honor/Memory of__________________________________
ð I want to support CATCO's annual fund drive with a gift of $____________
ð I also want to help CATCO meet its challenge from the Columbus Arts
Stabilization Project with an additional gift to help build working
capital funds $____________
My Total gift is $________
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Please charge
my contribution of $________ to my credit card:
ð Visa ðMasterCard
ðDiscover
ðAmerican
Express
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Account
number_____________________
Expiration Date______________________
Signature
__________________________
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