Name(s)________________________________________________________________________
Address________________________________________________________________________
City__________________________________
State__________________ Zip________________
Home Phone___________________________ E-mail____________________________________
* A matching gift donation can increase your membership level.
Please enclose a matching gift form from your employer, if applicable.
Enclosed is my check
for $________________, payable to FLWHEP.
Please charge $________________ to my credit card: MasterCard Visa Discover
Card Number_____________________________________ Exp. Date______________________
Signature______________________________________________________________________
TRIBUTE FUND
I wish to give a tribute gift of $__________ in honor of _______________________________
Occasion_______________________________________________________
I wish to give a tribute gift of $__________ in memory of _____________________________
Please send acknowledgement to:
Name_____________________________________________________________
Address___________________________________________________________
City___________________________ State______________ Zip_____________
Daytime Phone_____________________________________________________
According to IRS guidelines, the Friends of The Frank Lloyd Wright House in Ebsworth Park
must advise you of the amount of your membership gift that may be considered a charitable
contribution with a confirmation of your membership. Thank you for your support!
The Frank Lloyd Wright House in Ebsworth Park | CLOSE WINDOW
120 North Ballas Road St. Louis, Missouri 63122
314-822-8359 info@ebsworthpark.org
|