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Donors form - ESSEC Business School Alumni in the USA

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Donors form - ESSEC Business School Alumni in the USA Powered By Docstoc
					Thank you for your support!

2005-2007 ESSEC USA Campaign
USA1213 Please return to ESSEC USA C/o Guibert & Co. CPAs 149 East 36th Street New York, NY 10016

Name: _________________________________________ ESSEC program/ class year: ____________ Address: _____________________________________________________________________ _____________________________________________________________________________ Home phone: _____________ Business phone: ____________ Cell phone: ______________ Email address: ________________________________________________

 YES, I want to support the development of ESSEC with my donation of:  $200  $500  $1,000  $2,000  $3,500 ___________ other
 I enclose my check payable to ESSEC Business School Alumni Association If you want to pay by credit card: please contact Jean-Xavier Barthelemy jbarthelemy@guibertcpas.com

You may also make pledge over the 2005-2007 Campaign. You immediately become a member of ESSEC Donor’s Club if you pledge over $3,500:  I support the development of ESSEC by my pledge over the 2005-2007 Campaign of:  $3,500  $5,000  $9,000 (Club Premier)  $23,000 (Club Elite)  $58,000 (Club Exception) _____________other
FOR THE FIRST YEAR I enclose my check $

payable to ESSEC Business School

Alumni Association
 My Company _____________ has a matching gift program. (Please attach matching form if available)

If you want to give appreciated securities or for any questions you might have on how to give to ESSEC USA please contact Jean-Xavier Barthelemy jbarthelemy@guibertcpas.com
Recognition program: donor’s certificate, Campaign report, newsletter and more according your status. Annual giving Friend: From $170 to $799 Associate: From $800 to $1,699 Partner: From $1,700 to $3,499 Member of the ESSEC Donor’s Club (Cumulated gifts from 2005 to 2007) – Listing on the honor roll of donors and other advantages Club from $3,500 to $8,999 Club Premier From de $9,000 to $22,999 Club Elite from $23,000 to $57,999

Tax benefits ESSEC Business School Alumni Association (“ESSEC USA”) is a not for profit organization operating under section 501(c) 3 of the Internal Revenue Code. Gifts to ESSEC USA are deductible to the extent permitted by Law.

Club Exception $58,000 and over

ESSEC USA c/o Guibert & Co. CPAs 149 East 36th Street - New York, NY 10016 jbarthelemy@guibertcpas.com tel 212 447-1300 /fax 212 447-5017


				
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