* Indicates Required Field
Glassell School of Art Benefit and Auction
Friday, May 3, 2013


I am/We are pleased to support at the following level:*

Qty. Type Price Total
Major Underwriter Table
Prioritized table for 10 with seated dinner and cocktail reception. (fair market value $1,000)

$15,000
Underwriter Table
Preferred table for 10 with seated dinner and cocktail reception.
(fair market value $1,000)

$10,000
Benefactor Table
Table for 10 with seated dinner and cocktail reception.
(fair market value $1,000)

$5,000
Individual Sponsor Ticket
Individual ticket for seated dinner and cocktail reception.
 (fair market value $100)

$1,000
Individual Ticket
Individual ticket for seated dinner and cocktail reception.
(fair market value $100)

$500
General Admission
Individual ticket for admission at 9:00 p.m. to enjoy the silent art auction and passed desserts. (fair market value $25)

$100

I/We cannot attend, but enclosed
is a fully tax-deductible donation of $:


 
Total Charge:  


After Fair Market Value (FMV) is applied, the remainder of your gift is tax-deductible.

I wish to waive all benefits and make this gift 100% tax-deductible.

Name (as you wish to appear on all printed materials):

Personal Information:

Title:Mr.  Mrs.  Ms.  Miss

Last Name*:


First Name*:




Corporate Contact:


Address*:



Address 2:


City*:



Zip / Postal Code*:
State / Province*:

Country:


E-Mail*:



Phone Number*:



Payment Information:

Credit Card Type*:


Expiration Date*:


Credit Card Number*:


Security Code*:



Billing Information:


Same as Personal Information

Title:Mr.  Mrs.  Ms.  Miss

Last Name*:


First Name*:


Address*:



Address 2:


City*:



Zip / Postal Code*:
State / Province*:

Country:




For information, contact Development Special Events at 713-639-7523
Email GlassellBenefit@mfah.org Fax713-639-7595.




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2013 The Museum of Fine Arts, Houston