The Geauga County Wind Ensemble

Name of Sponsor(s) Date

Address

City State Zip

Home Phone Work Phone

Email Web Site Address

Select the sponsorship level and enter the amount donated:

Friendship Level $10 - $149
Member Level $150 - $299
Assistant Director Level $300 - $699
Director Level $700 - $999
Benefactor Level $1,000 or above

Some or all of your sponsorship may qualify as a tax deduction; please keep a copy for your records. Check with your accountant or a tax professional for details.

Make checks payable to The Geauga County Wind Ensemble or fill out the information below to use a credit card:

Check the type of Accepted Card to be used:

Visa

MasterCard

Credit Card No.

Expiration Date

Signature X_______________________________

Note: The boxes on this form are for printing purposes only. Your credit card information will not be sent over the internet. Do not email credit card information.

Fill in the boxes on this form, print it out and return it to:

The Geauga County Wind Ensemble
P.O. Box 736
Middlefield, Ohio 44062

You can also drop off any donations at

Roadhouse Music, 15910 West High St., Middlefield, Ohio 44062

Or Call (440)632-0678 to make other arrangements.

Thank you for your support!