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Individual Partner Gift Pledge

Yes! I would like to become a Partner of the Fox Cities Performing Arts Center

Enclosed is my annual contribution amount: $

The Partnership Level I would like to have is: $
I would like to waive my benefits in order to receive the maximum tax deduction allowed by law.

Please enter your information

First Name:

Last Name:

I would like to remain anonymous

Name as you would
like to be recognized:

Email Address:

Phone Number:

Address:

City:

State:

Zip Code:

Please indicate method of payment

Credit Card Type:

Credit Card Number:

Name on Credit Card:

Expiration Date:

Yes, my company matches my gift
If yes, please send matching gift form to:

Fox Cities Performing Arts Center
Attn Development
400 W. College Ave.
Appleton Wi. 54911

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