To make a donation in support of the Museum, Arts and Culture Access Consortium’s efforts, please print the form below, fill in the information as requested, and mail it to the address at the bottom of this page or email it to [email protected]. If you are making your donation by check, please be sure to make the check payable to “Fund for the City of New York” and indicate “For the Museum, Arts and Culture Access Consortium” or “MAC” in the memo line.
Enclosed is a gift in support of the Museum, Arts and Culture Access Consortium, payable to “Fund for the City of New York “, MAC’s fiscal sponsor.
Gift Amount:$_____________
Your Name: ____________________________________________________________________
Address: ______________________________________________________________________
City: _________________________ State: _________________ Zip: _______________
Email: __________________________________ Phone: _______________________________
Method of Payment Information:
Payment Method: ____ Check, ___Amex, ____Visa, _____MC
(All gifts made by check should be made out to “City Access New York, Inc.” with “MAC” or “Museum Access Consortium” in the memo line)
Name on Card: ________________________________________________________________
Account #:_________________________________________Exp. Date: _________________
Signature: ____________________________________________________________________
Gift designation:
Please designate my gift as a tribute to: __________________________________________
Anniversary:___ Memorial:___ Birthday: ___ Other: ____________________________
Please send notification of this gift to:
Name: ________________________________________________________________________
Address: ______________________________________________________________________
City: _________________________ State: _________________ Zip: _______________
Email a scanned copy of this form to [email protected]
or
Mail it to: Museum Access Consortium c/o Fund for the City of New York, 121 6th Ave # 6, New York, NY 10013