Greater Derry Arts Council
Member and Donor Form

Please fill out this form and submit it to us. We will then send you a membership or donor invoice (since we don't at this point accept electronic payments). Gifts are tax deductible to the fullest extent permitted by IRS regulations.

Note: * indicates a required field.

Name: *

E-Mail Address:

Street Address: *

Town or City: * State: * ZIP-Plus-4 Code: *

Membership Category (please select one):
   Membership Pledge Amount:   $  
Default Pledge Amount is the base amount for the selected category.

I am also interested in giving some of my time to the following Greater Derry Arts Council Committees:

Programming     Marketing     Newsletter / Public Relations    Fund Raising

Opera House Restoration    Opera House Management    Grant Writing

 

 

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