P.O. Box 161
Newark, DE 19715-0161
Annual Fund Donation Form
Yes! I want to support the continuing growth and artistic excellence of Mid-Atlantic Ballet.
This donation is for:
□ Benefactor: $1,000 or more
□ Patron: $500 - $999
□ Partner: $250 - $499
□ Fellow: $100 - $249
□ Friend: up to $99
Amount Enclosed: $____________
Your donation is 100% tax deductible. All recipients and donors with donations of $25 or more will be
listed in our 2014-2015 program books. Please complete the form below as you would like to see the
names in our program books.
Donation given by __________________________________________________________________
Address__________________________________________________________________________
City__________________________________________________State____________Zip_________
Email____________________________________________________________________________
Donation in honor/memory (circle one) of
Thank you for your generous support! Please keep a copy of this form for your records.
Mid-Atlantic Ballet’s Tax ID number is 52-2058530.100% of your donation is tax deductible.