Please print the blank form.  Return the completed form by fax or mail to the address below.

The Brearley Benefit 2006 Underwriters Form

"Cincotti in Concert"

Wednesday, May 24, 2006 at 7:30 p.m.

Frederick P. Rose Hall
Home of Jazz at Lincoln Center (Broadway at 60th Street)
 



  Name(s): ____________________________________________

Step 1: Choose the level at which you would like to support this special effort to increase faculty pay at Brearley.

$15,000        $10,000        $7,500        $5,000        $2,500

Step 2:    Tell us how many tickets to reserve for you.  (Each ticket decreases the amount of your tax deductible gift by $75 for each adult ticket and $50 for each student ticket.)
Please reserve _____ adult tickets and ______ Upper School student tickets for the Brearley Benefit on May 24, 2006.

 

Step 3:    Choose the payment method you prefer

 My check made out to the Brearley School is enclosed.

I would like to give a gift of stock. (Please click here for stock donation instructions)

Charge my credit card for the amount indicated above.

Name as it appears on card: _________________________

Card # ______________________________Exp. Date ______/______
 

 

Step 4:     Help us say "Thank you" for your generous support.
I/we prefer that my/our name(s) to be listed in the program this way:
________________________________________________
(Our standard format is: Mary and John Doe)

I/we would prefer not to be included in the list of underwriters in the program.


Step 5 : Increase your gift with a match from your employer

My company will match the deductible portion of my gift. I’ve enclosed the form.
 

 

YOU MAY FAX THIS FORM TO BREARLEY AT 212-570-8630
or mail to The Brearley School, Development Office, 610 East 83rd Street, New York, NY 10028

To be listed as an underwriter in the Benefit Program, return this form to the Development Office no later than April 11.