Membership WSO Society Order Form 2009 - 2010 Season

YES . . . I would like to support the symphony by:

__ Renewing my membership in the WSO SOCIETY
__ Becoming a first-time member of the WSO SOCIETY


With the four gift levels listed below, I understand that my name will be listed in each concert program (if received by Sept. 24) and I will receive two tickets to all 3 concerts.

__ Chair - $1000   __ Benefactor - $750   __ Patron - $500   __ Donor - $300

Note: If you or your spouse is affiliated with a company that matches gifts to non-profits, please send the company application with your gift to us.

With a $35 gift ($1 for each year), you will be listed as a WSO Friend.

I should like to make this gift to the WSO in honor of ________________________________________________
Any gift amount would be greatly appreciated.  __________

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Payment method: __   Check enclosed   __ Visa   __ MC

Card #   ________________________________ Exp. Date ________

Credit card signature   _____________________________________

Total Amount enclosed or charged $_____________

Name   _________________________________________________

Address   _______________________________________________

City   ________________________  State _____   Zip __________

Phone   ________________________

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Send to:

WSO
P.O. Box 6023
Wallingford, CT 06492

Phone: (203)697-2261