TELL US about yourself:

I wish to be recognized I wish to remain anonymous

Your Name as you would like it to be listed in programs and/or annual reports:

EMPLOYER MATCHING:

My employer will match my gift (click box if yes) Employer Name: Payment will be mailed I will mail the matching form to the Westport Country Playhouse

Tribute:

I wish to make my contribution: In Honor of: In Memory of:

Please mail a card on my behalf Mail to: Name: Address: City: State: Alaska Alabama Armed Forces Arkansas American Samoa Arizona California Northern Mariana Is. Colorado Connecticut D.C. Delaware Florida Micronesia Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Marshall Islands Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Palau Rhode Island South Carolina South Dakota Tennessee Trust Territories Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming Zip:

Thank you for your support of the Westport Country Playhouse

If you have any questions regarding our Annual Fund or giving to the Playhouse, please call our donor services hotline: (203) 227 – 5137 x122.

The Westport Country Playhouse is a 501(c)(3) organization. Tax receipts will be sent by mail from the Westport Country Playhouse, 25 Powers Court, Westport, CT 06880.