20th Anniversary Pledge Form by KevinCrouthers

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									20TH ANNIVERSARY GALA PLEDGE FORM
Wednesday, October 7, 2009

I/We are pleased to support the 20th Anniversary Gala at the following level:

____ $500 Ticket                ____ # of Ticket(s)      ($100 non tax-deductible per ticket)

____       $1,000 VIP Ticket    ____ # of Ticket(s)      ($260 non tax-deductible per ticket)

____       $7,500               Ticket Package           (1,000 non tax-deductible)

____       $25,000              Copper Sponsor           ($2,600 non tax-deductible)

____       $50,000              Silver Sponsor           ($5,200 non tax-deductible)

____       $100,000             Gold Sponsor             ($7,800 non tax-deductible)

____       $250,000             Platinum Sponsor         ($13,000 non tax-deductible)

____   Contribution             I/We are unable to attend but would like to make a contribution to
                                support the National Museum of the American Indian on the
                                occasion of its 20th Anniversary.

Name: ________________________________________________________________

Company Name (if applicable): ____________________________________________

Address: _______________________________________________________________

City: __________________________________ State: _____ Zip: ________________

Daytime Phone: _____________________ Evening Phone: _____________________

Email: ________________________________________________________________

Signature: ______________________________________________________________

Credit Card No. (optional): ________________________________________________

Expiration Date: _____ /_________

Tax Identification Number: 53-0206027

Please make checks payable to: National Museum of the American Indian

Mail to:

Pat Kramer, Director of Special Events
National Museum of the American Indian
P. O. Box 23473
Washington, DC 20026-3473

Or print and fax this form to Pat Kramer at 202-633-6920.

								
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