Back Bay Chorale Donation Form

Please check here __ if you do NOT wish to be recognized
in our programs.

Name: _____________________________________________

Address: __________________________________________

City: _______________________ State ____ ZIP ______

Telephone: ________________________________________

Email address: ____________________________________

I would like to make a donation of: $ _________.

Please choose from the following options.

__ A check made out to the Back Bay Chorale is included.

__ bill my Credit Card: __ VISA __ MASTERCARD

Credit Card Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Expiration Date _ _ /_ _ / _ _

Please return this form to:

The Back Bay Chorale
Sponsorship Program
P.O. Box 61, Back Bay Annex
Boston, MA 02117

or call (617) 648-3885 for more information.