Support the Patrons of the Philharmonic


Required fields are marked with asterisks (*)
Choose one: *
 I am joining the Patrons of the Philharmonic.
 I am renewing my Patrons of the Philharmonic membership.
 I am making an additional gift to the Patrons of the Philharmonic.
 I would like to give a gift membership. (Please provide recipient's information under "Gift Membership" below.)
Mailing Information
Title
First name*

Last name*

Home street address*

City*

State*
Zip/Postal Code*   
Home telephone*
  (format: XXX-XXX-XXXX)
Home e-mail*

Company name

Title

Business street address
City

State
Zip/Postal Code   
Business telephone
  (format: XXX-XXX-XXXX)
Business e-mail

 Please use my business address.
Membership Level*
 Please consider making an increased gift.
Payment
Please charge* $  to my* 
Credit Card Number*
  Exp. date*     (format: MM/YY)
 I wish to make quarterly payments.
 I prefer to make a gift of appreciated securities.
Matching Gift Information
I will mail the matching gift form in the amount of $ 
from   which may be applied to my membership level.
(Company name)
Program Listing

Please include my listing in the program as 
 I wish to remain anonymous.
Young New Yorker (YNY) Patrons
 I would like to become a YNY Patron (ages 21-40).
Tax Deductibility

The New York Philharmonic is a not-for-profit institution. All contributions are tax deductible less the fair market value of the benefits provided, unless you indicate that you wish to decline the benefits.
 I wish to decline all benefits to claim the full tax deduction for my gift.
The Heritage Society
 I have included the Philharmonic in my will and wish to join the Heritage Society.
 I am interested in receiving information on ways to support the future of the Philharmonic and receive tax benefits.
Gift Membership
 I/We would like to give a special Gift Membership.
Please indicate recipient's name and address and Gift membership:
Title

First name

Last name

Street address

City

State
Zip/Postal Code   
Telephone
  (format: XXX-XXX-XXXX)
 Please send renewal notice to me.
 Please send renewal notice to my friend.

Honorarium/Memorial Gift
 I/We would like to give an Honorarium/Memorial Gift.
I would like to make a gift of $ 
In honor of
(name as you wish it to appear in Annual Report listing)
In memory of
(name as you wish it to appear in Annual Report listing)
Please acknowledge this gift to:
Title

First name

Last name

Street address

City

State
Zip/Postal Code   
Telephone
  (format: XXX-XXX-XXXX)

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