anniversary MAKING A DIFFERENCE THROUGH THE ARTS Awards Dinner, Gala, and Auction May 19, 2015 LUXURY GOODS & SERVICES SILENT AUCTION FORM Thank you for contributing to CITYarts’ 47th Annual Awards Gala and Auction. Please return this form by May 10, 2015 to confirm participation and to be included in the invitation. Company / Organization Name: Contact Person: Address: City: Telephone: Email: State, Zip: DONATION DETAILS please list as it should appear on printed materials, and add the retail price for your tax deductible contribution letter Luxury Goods/Services Description Retail Price For further information, please contact CITYarts at 212 966 0377 or at [email protected]. Please return this form to CITYarts by fax at 212 966 0551 or mail to the address below. We are not able to donate a product but would be happy to contribute to CITYarts. Amount: $ CITYarts is a 501(c)3 organization. Contributions and donations are fully tax-deductible. AMEX MC Visa Other Card #: Exp. Date: Name on Card: Signature: Or please make checks payable to: CITYarts, Inc. and send to the address below. Thank you for your donation. Your generosity truly makes a difference. 525 Broadway, Suite 602 | New York, NY 10012 | T 212 966 0377 | F 212 966 0551 | [email protected] | www.cityarts.org