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  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


Mail it to: Museum Access Consortium c/o City Access New York, 1207 Castleton Avenue, 2nd Floor, Staten Island, New York 10310