Donor Form

Help us finish the year with a balanced budget by making a tax deductible gift today. We welcome your contribution of any size.

Please fill out the form below. When you are finished, you can either click on the submit button to send it to us, or you may print out the form and mail it along with your donation to:

Charlotte Symphony
 Midtown Plaza
1300 Baxter Street
Suite 300
Charlotte, NC 28204

Please provide the following contact information:

Name:
 


As you wish to be listed in the program book

Address:

City:

State:

Zip Code:

Work Phone:

Home Phone:

E-mail:

Membership Categories

Platinum Podium $25,000+

Gold Baton  $12,000-$24,999

Conductor’s Circle  $6,000-$11,999

Founder $3500-$5,999

League Benefactor  $2,000-$3,499

Patron $1,250.00-$1,999

Affiliate Member $750-$1249

Sustaining Member  $500-$749

Contributing Member  $250-$499

Friend $1-$249

 

 
I/We pledge:

$

Please charge my credit card:
 

    Credit Card

    Cardholder Name

    Card Number

    Expiration Date

Please send me an invoice to the address listed above
My employer, , will match my gift. I will mail you a matching gift form.

I do not wish to receive any benefits which reduce the tax-deductible value of my gift.

I want to designate my gift to the Oratorio Singers of Charlotte.

I want to designate my gift to Healing Hand hospital visits.

I want to designate my gift to Charlotte Symphony Youth Orchestras.