____ YES, I would like to support the continued improvements and cultural programs at the Colonial Theatre with a tax deductible gift of:
____$1000 ____$500 ____$250 ____$100 ____$50 ____Other: $____
Name (please print) _____________________________________________________________
Mailing Address _____________________________________________________________
City _____________________________________________________________
State/Zip _____________________________________________________________
Daytime Phone (____) ______________________
Email_________________________________
____ Enclosed is my check payable to Friends of the Colonial.
____ Charge my donation to ____ Visa ____ MasterCard ____ Discover
Card # ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Expiration Date ___ ___/___ ___
____ Please acknowledge my gift of $250 or more with a plaque on a newly renovated theatre seat.
____ I/we would like to make my gift in the form of appreciated securities, please contact me.
____ Please contact me regarding bequest and planned giving opportunities.
____ My employer will match my gift, enclosed is my company's matching gift form.
____ I prefer my gift remain anonymous.
____ Keep me informed with the Colonial's e-announcements.
Please mail payment to: Colonial Theatre, PO Box 204, Bethlehem, NH 03574.
THANK YOU FOR YOUR SUPPORT
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