CONTRIBUTION FORM

  Print and return to:
    Studio 96
    PO Box 14
    Sterling, KS  67579
               
   I would prefer my contribution be kept confidential _______
   I would prefer my name and contribution be kept confidential  ______
   Last Name _________________________ First Name _______________________
   Address ____________________________________________________________
   City _________________________ State _________________ Zip _____________
   Telephone: Home ______________________   Work ________________________
   E-Mail address ___________________________________________
   
 

Annual Membership Fee Schedule

Individual..............................

$ 25

Family..................................

$ 50

Patron..................................

$ 100

Benefactor............................

$ 500

Would you like to volunteer your time, resources, or ideas to Studio 96?    YES !!!


STUDIO 96
Receipt of contribution

Date __________________________
Received of __________________________
Contribution amount __________________________

We sincerely thank you !!

Studio 96 is a 501c3 nonprofit organization.
Contributions are tax deductable.


location:
Studio 96, Inc.
121 South Broadway
Sterling, KS  67579

mailing address:
Studio 96, Inc.
P.O. Box 14
Sterling, KS  67579

e-mail:
cynthia@studio96.org
webmaster@studio96.org

copyright 2009 Studio 96, Inc.
updated 07/2017