Vicksburg Theatre Guild Building Fund Donation
Federal tax identification number 64-0386859

Name:____________________________________________

Street/PO Box:______________________________________

City/State/Zip:______________________________________

Contribution

□  Platinum ($1,000 or more)

□  Gold ($500 to $999)

□  Silver ($100 to $499)

□  Bronze ($5 to $99)

□  I wish to remain anonymous.

Please make check payable to “VTG BFA Account.” and mail to:
Vicksburg Theatre Guild
P.O. Box 821472
Vicksburg, MS 39182

VTG is a 501(c)(3) tax-exempt organization. Tax-deductible donations
may be made, as provided in Section 170 of the U.S. Internal Revenue Code.