Kirkland Printable Donor Form

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I WANT TO HELP SAVE THE KIRKLAND!

Yes, I’m interested in aiding RUPCO’s mission to revitalize the Kirkland Building.

All donations in any amount are completely tax-deductible. An added incentive for contributions of $500 or more to the Kirkland Fund is the option of taking a 25% NYS income tax credit for donors based on the amount given in place of a deduction.


YOUR INFORMATION
Enclosed is my tax-deductible contribution of:
In addition to my contribution, I would also like to purchase a limited edition etching:
$175.00 (unframed) $225.00 (framed)
Name:
Street:
City:
State:
Zip:
Phone (day):
Phone (evening):
e-mail address:
How do you wish your name to be listed for donor recognition:
I wish to remain anonymous.


MATCHING GIFT INFORMATION (Fill out this section only if you are eligible for a matching gift from your employer.)
I/we are eligible for a matching gift from my/our employer.
Name of employer:


SPREADING OUT YOUR CONTRIBUTION OVER TIME (Fill out this section only if you would like to donate over a specific time period.)
I wish to spread my contribution out over 1, 2, or 3 years (min. donation of $500)
Send me a reminder: Quarterly, Semiannually, or Annually


PAYMENT METHOD
Make checks payable to: RUPCO - Kirkland Fund
Please charge my gift of $________________ to the following credit card: MasterCard or Visa
Card #:
Signature:


HONOR AND MEMORIAL GIFTS
This gift is in memory/honor of:
Please acknowledge the memorial gift (but not the amount) to:
Name:
Address:


Mail to: Rural Ulster Preservation Company, 289 Fair Street, Kingston, NY 12401.

Thank you for supporting RUPCO.


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