Print and Mail form

Give a tax-deductible gift . . .
Take a bow.

Name(s) ________________________________ 
  (as you wish to appear in our programs)             
Address_________________________________  
City /State_______________________________  
Zip code + four_________________     
Telephone_____________________
Enclosed is my gift of $__________
$25,000 $1,000
$15,000 $500
$10,000 $250
$5,000 $100
$2,500 $50

Charge my gift: MasterCard Visa

Card # ___________________________ exp. date__/__

Signature required ________________________

Make check payable to Penobscot Theatre Company
All 1999 calendar year gifts will be recognized in our 1999 - 2000
25th Season programs!
 
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