GRETNA THEATRE DONOR FORM

Please print out this form and mail with your check to:

GRETNA THEATRE   PO BOX 578   MT. GRETNA, PA  17064

(Don't forget to enclose your Employer Match form if you have one!)

Fax Credit Card donation orders to 717-964-2189

Name __________________________________________________________

                                            (As you would like it to appear in the 2008 Summer Program)

Address ________________________________________________________

City _________________________________ State ______ Zip ____________

Phone ________________________E-mail ____________________________

             ___ My Check is Enclosed                       ___ Please charge my Credit Card

Card Number _____________________________________ Exp. Date ______

Signature for Credit Card Contributions ________________________________

Special Instructions:

____I/We would like my/our gift to be anonymous

____I/We would like my/our gift to be in the memory of:_________________

____I/We have a matching gift from an employer and enclose the matching gift application.

Coghlan Society  Coghlan Society Gift Levels start at $500.

Patrons

Other Gift Amount:  $__________

THANK YOU FOR YOUR GENEROUS AND VITAL SUPPORT AS WE GO INTO ANOTHER GREAT SEASON AT GRETNA THEATRE!  

(Click here to go back to the Donor Info Page)