Contribution Form

Please print this form and mail it with your check to the Symphony office at the address below.

Level of Giving	Donation
Concertmaster’s Club	$5,000
First Chair Club	$2,000
Major Benefactor	$1,000
Benefactor	$750
Chair Sponsor	$500
Sponsor	$250
Major Contributor	$100
Contributor	$50
Other	$_____
Total Donation	$
MY TOTAL GIFT IS	$

Chair Sponsorship
Join the list of organizations and individuals sponsoring our fine orchestra! A gift of $500 sponsors the musician of your choice for the entire season.

Instrument Choice

Musician Choice

Name (as you wish it to appear in the program)

Address

City and ZIP Code

Phones: Day and evening (w/ area codes)

The Dearborn Orchestral Society is a 501 (c) (3) non-profit charitable organization. Donations are tax-deductible to the extent permitted by law.

Please make checks payable to the Dearborn Orchestral Society, Inc. and mail with this page to:

Dearborn Symphony
P.O. Box 2063
Dearborn, MI 48123

Dearborn Symphony Orchestra
P.O. Box 2063
Dearborn, MI 48123
Phone: 313.565.2424
Email: info@dearbornsymphony.org