To make a donation in support of the Museum 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 museumaccess@gmail.com. If you are making your donation by check, please be sure to make the check payable to “City Access New York” and indicate “For the Museum Access Consortium” or “MAC” in the memo line.
Enclosed is a gift in support of the Museum Access Consortium, payable to “City Access New York, Inc.”, 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 museumaccess@gmail.com
or
Mail it to: Museum Access Consortium c/o City Access New York, 1207 Castleton Avenue, 2nd Floor, Staten Island, New York 10310