Donation Card
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My Gift Donation Levels Angel Producer Director Lead Actor Actor Supporting Cameo
$2000 + $1000 - $1999 $500 - $999 $250 - $499 $100 - $249 $50 - $99 $10 - $50
Name_____________________________ List As_____________________________ Street______________________________ Town______________________________ State________________Zip____________
Thank you for your tax-deductible gift in the amount of $____________________ Payment Method: Check Mastercard
Visa
Credit Card # ____________________________________ Expiration Date________CVV code_______ Please make checks payable to: Lakewood Theater P.O. Box 331 Skowhegan, ME 04976
$2000 + $1000 - $1999 $500 - $999 $250 - $499 $100 - $249 $50 - $99 $10 - $50
Name_____________________________ List As_____________________________ Street______________________________ Town______________________________ State________________Zip____________
Thank you for your tax-deductible gift in the amount of $____________________ Payment Method: Check Mastercard
Visa
Credit Card # ____________________________________ Expiration Date________CVV code_______ Please make checks payable to: Lakewood Theater P.O. Box 331 Skowhegan, ME 04976
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