Donation Information

All contributions of $125.00 and greater are eligible for membership benefits. New memberships will be in effect for one year from the date of donation. Renewals will be extended for one year beyond your current membership's expiration date.

New Membership level: those who are 35 and younger can become a 35 Mainstage Millennial member for just $50. At the (35MM) level you receive all the Mainstage Benefits including access to the Season Announcement Party on May 23, 2018.

If you have any questions about your donation please email membership@lvpac.org or call 925.583.2305.

Please complete the form below and click on "Submit" to make your tax-deductible donation.

To submit this form, all "*" fields must be filled in.

Contact Information

First Name*

Last Name*

Street Address*

City*

State* UNITED STATES Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming CANADA Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

Zip*

Daytime Phone*

Evening Phone

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Birth day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Birth year 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901

Email*

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Membership Information

Check all the items that apply

New

Renewal

Donation Amount*

Membership Level

Mainstage ($125)

Applause ($250)

Encore ($500)

Ovation ($1,000)

Artiste ($2,500)

Maestro ($5,000)

Virtuoso ($10,000)

Impresario ($25,000+)

35MM ($50) ~For Members 35 years of age or under. Please add your Birthday to the Special Instructions.~

My gift is for:

The Greatest Need

LVPAC Education Fund

Student Ticket Fund

Bothwell Arts Center

My employer will match my contribution.

Please see your Human Resources department for information on your employer's matching gift program.

Joint Gift?

Is this a joint gift with your spouse/partner? Yes No

Spouse/Partner First Name

Spouse/Partner Last Name

Payment Information

Card Type* Visa MasterCard Amex Discover

Card Number*

Expiration Month* 1 2 3 4 5 6 7 8 9 10 11 12

Expiration Year* 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028

Card Security Code*

We recognize Annual Donors by listing them in the program and on the donor wall.

Please list my/our name as:

I prefer to remain anonymous

Special Instructions