Name: ____________________________________________________________
Organization Name: _________________________________________________
Address: __________________________________________________________
City: _________________________ State: ____________ Zip: _______________
Email: _____________________________________________________________
Phone: ____________________________
Mark one: [ ] Individual Donation [ ] Business donation
Amount: ______________
Make Payments: [ ] Monthly [ ] Quarterly [ ] Semi-Annually [ ] Other __________
Payment type: [ ] Check enclosed [ ] Visa [ ] Master Card [ ] Am Ex
Credit card number: _________________________________ Exp: ____________
Credit card security number (3 digits from back of card): ________
Signature: __________________________________________________________
Make checks payable to: Urban League of Greater Madison
Mail completed form to: Urban League of Greater Madison, 151 E. Gorham St., Madison, WI 53703
| President's Circle |
$500 |
$5,000 |
| Honor Roll |
250 |
2,000 |
| Friend |
100 |
1,000 |
| Supporter |
35 |
500 |
| Limited Income/Youth/Senior |
10 |
|
|
I would also like to help with a donation to the Youth Endowment Fund:
[ ] Superhero $1,000
[ ] Hero $250
[ ] Other Amount $________ |
|
|
[ ] Please contact me about the many tax and other benefits of making my gift in the form of stocks, securities, etc.
[ ] I am considering leaving a lasting Urban League legacy through my will.
[ ] I would like to know more aobut supporing the Urban League as a volunteer.
[ ] Please keep my contribution anonymous
[ ] I do not wish to receive mailings such as the quarterly newsletter or future solicitiations.
[ ] I do not wish to receive email alerts, program updates, announcements, etc.