TAX-DEDUCTIBLE CONTRIBUTION TO:
FRIENDS OF NORTH SHORE SYMPHONY ORCHESTRA

PLEASE PRINT CLEARLY

Contact Name:     ____________________________________________________________________________________________________
Business Name:     __________________________________________________________________________________________________
Mailing Address:    __________________________________________________________________________________________________
(street, city, state, zip)
Email Address:    ____________________________________________________________________________________________________
Phone Number:     __________________________________________________________________________________________________
 
[ ] $10-$24 Friend
[ ] $25-$99 Donor
[ ] $100-$299 Sponsor    
[ ] $300-$499 Patron    
[ ] $500-$999 Benefactor
[ ] $1,000-$4,999 Golden Circle
[ ] $5,000+ Platinum Circle
[ ] Dwight E Dyer Concermaster Chair
[ ] $2,000 Sponsor an NSSO concert or a named chair (or co-sponsor at 1/2)

Enclosed is my total contribution in the amount of $ ________________________

[ ] I do not wish my name to appear as a contributor in the NSSO program.

PAYMENT OPTIONS:
Pay via PayPal: https://www.paypal.com/ncp/payment/R7DP6ZMVA5TKG
Send check payable to: Friends of North Shore Symphony Orchestra
P.O. Box 419  | Greenvale, NY 11548-0419

If your employer has a program to match charitable gifts by employees, please let us know how to request a matching gift. Friends of NSSO is a not-for profit corporation under 501(c)(3) of the IRS tax code; all contributions are tax-deductible. EIN: 11-3592182

THANK YOU FOR YOUR SUPPORT!