League of Historic American Theatres - Sponsors and Donors

Mail/Fax Donation

If you would like to make a pledge and have LHAT bill you in one, two or three equal installments, please complete the following form and click the Format button below. Print the page and mail or fax it the League of Historic American Theatres. Upon receipt, we will mail or email you a message confirming your pledge, and then follow up with an invoice(s) on the agreed upon date(s). A receipt will be mailed to you after each payment is processed.

Complete the following form and mail with your check or money order to:

League of Historic American Theatres
334 N. Charles Street, 2nd Floor
Baltimore, MD 21201 USA

tel: (410) 659-9533
toll-free: (877) 627-0833
fax: (410) 837-9664

(Visa, Mastercard, American Express & Discover
also accepted by phone, fax or mail)

Accept my pledge in the amount of:

		$50 Friend
		$100 Supporter
		$250 Sustaining
		$500 Benefactor
		$1000 Patron
		Other, Please Specify Below...

For amounts less than $250:
		Please bill my credit card 30-days from today.

For amounts exceeding $250:
		Please bill my credit card in two equal installments, to be paid 30 and 90 days from today.
		Please bill my credit card in three equal installments, to be paid 30, 90 and 150 days from today.

NAME:
TITLE:
ORGANIZATION NAME:

ADDRESS:
SUITE/FLOOR/APT:
CITY:
STATE:
ZIP:

TELEPHONE:
FAX:
EMAIL:

Credit Card Type:
Card Number:
Expiration Date:		(mmyy - Example: 0502)

All donors are acknowledged in our newsletter, inLEAGUE, and on LHAT's website. List my name as follows:

I wish to remain anonymous.

All contributions are tax-deductible to the extent allowed by law.

THANK YOU FOR SUPPORTING
THE LEAGUE OF HISTORIC AMERICAN THEATRES