Show Your Love for the Arts!

 

If you would like to mail your contribution,
you can download the PDF version of the form
below, please print and fill out the form, then
send it with your tax deductible contribution to:

Cleveland County Arts Council
111 South Washington Street
Shelby, NC 28150


Cleveland County Arts Council Individual Donation Form

Please complete this form, and enclose it with your payment, payable to:  Cleveland County Arts Council.
Mail to: Cleveland County Arts Council
111 S. Washington St.
Shelby, NC  28150.

Name (as you wish listed): ______________________________________________________________
Address: _____________________________________________________________________________
City, State, ZIP Code: _________________________________________________________________
Phone number: _______________________________________________________________________
E-mail address: ________________________________________________________________________

I would like to support Arts Council as a/an:

_ Benefactor ($5,000+)
_ Art Connoisseur ($2,000+)
_ Art Patron ($1,000+)
_ Art Collector ($500+)
_ Art Enthusiast ($250+)
_ Art Curator ($150 +249)
_ Art Lover ($75+)
_ Art Advocate ($50+)
_ Art Friend (less than $50)

Amount enclosed: $_______________________________________________________

I'm making a gift by:    _ Cash    _ Check    _ Visa    _ MasterCard    _ Monthly Bank Draft (see below)

Bill me:    _ Quarterly    _ Once in the month of __________________

Card #: __________________________________________________________________
Expiration Date: _________________________________________________________
Signature: ______________________________________________________________

 Bank Draft Authorization

For the period dating   ________- ________, I authorize the Cleveland County Arts Council to debit my bank account on the 15th of each month to collect my pledged amount to the Arts Fund Drive.

Total Pledge Amount $________________________    Amount per month $ ______________

*Please attach a voided check

 Memorials and Honorariums

Cleveland County Arts Council welcomes contributions in honor of those living and/or in memory of those departed. Memorials and honorariums are a fitting way of showing love and respect and/or recognizing individuals for their community service or their good life in general.

If your donation is being made in memory or in honor of someone special please complete the following:

In Memory of: ________________________________________________________
In Honor of: __________________________________________________________

Please send an acknowledgement card to:

Name: _________________________________________________________________
Address: _______________________________________________________________
City, State, ZIP Code: _____________________________________________________

The Cleveland County Arts Council is a 501(c)(3) nonprofit organization under the regulations of the Internal Revenue Service.
All contributions to the Arts Council are tax-deductible to the extent provided by law.
Thank you!

 
 
111 S. Washington St., Shelby, NC 28150   -   Phone: 704-484-2787   -   Email: info@ccartscouncil.org