2022-2023 Chambersburg Ballet Donation Form

Donation to the Annual Fund

I would like my Gift to the Annual Fund to be be used where the need is the greatestI would like to allocate my Gift to the Annual Fund to Guest Artists and ChoreographersI would like to allocate my Gift to the Annual Fund to Community EngagementI would like to allocate my Gift to the Annual Fund to Annual Performances (Nutcracker & IceFest)2023 Capital Campaign

Gift Recognition

I would like my Gift to remain anonymousI would like my Gift to be in honor/memory of an individual

In honor/memory of (name):

Donation Amount

USDDescription

If you are interested in Pledging a Gift paid in installments over a certain period of time, for more information, please email Cierra Neil at thechambersburgballet@gmail.com

Donor Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Phone Number*

Area CodePhone Number

Payment*

CheckDebit, Credit Card or PayPal

Please remit check payments to:

The Chambersburg Ballet Guild

PO Box 961

Chambersburg, PA 17201

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.