Sponsorship Form

Meridian Artists' Co-Op Sponsorship Form
(Please print form and mail form w/check to address below)
We thank you for your Donation to help support our organization and its programs.

Mr/ Mrs/ Ms/ Mr & Mrs/ Dr

NAME:___________________________________________________________
   (As you would like it to appear on our sponsorship roster, in newsletters and in the Annual Report)

I am a new Meridian Artists' Co-Op Sponsor.   YES   NO

I am renewing my Meridian Artists' Co-Op Sponsorship.    YES   NO

I am a renewing Meridian Artists' Co-Op Sponsor, but my information has changed. YES NO

Street Address:

City:

State/Zip Code:

Home Phone:

Cell Phone:

Email:

Please send me information electronically.   YES       NO

Sponsorship Levels
(Please circle $ amount)

Associate Sponsorship

$100

Friend Sponsorship

$200

Family Sponsorship

  $300

Patron Sponsorship

$400

Contributor Sponsorship

$500

Partner Sponsorship

$1,000

"In Memorium" Sponsorship

$2,500

Benefactor Sponsorship

$5,000 or more

A donation in the amount specified:

$ ___________

______ A check payable to Meridian Artists' Co-Op for $______________ is enclosed.

--------------------------- OR-------------------------

______Please charge $____________ to the following credit card:

       ______Master Card    ______Visa   ______Amer Exp    ______Discover

ACCT#__________________ Exp date:____________ VIN#______

Signature:_____________________________

I would like to make an additional contribution of $___________ to the Meridian Artists' Co-Op for:

Exhibitions and Shows

Childrens' Art Education & Workshops

Building Fund

Other Purpose: ________________________________________________

General Operating Fund

Regional Art Show

Please contact me with information on the :

                     ________Volunteer Program

                    ________ Friends of Gallery Program

                    ________ Workshops / Classes

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