inspire and educate through Chinese cultural arts. Below is my contribution:

Please print this form and send it to:

NY Chinese Cultural Center: 390 Broadway, 2nd fl. NY, NY 10013

❑ $50 – Bamboo Donor

❑ $150 – Silk Donor

❑ $250 – Porcelain Donor

❑ $500 – Jade Donor

❑ $750 – Bronze Donor

❑ $1000 – Gold Donor

Name

Address

Phone E-mail

❑ My check is enclosed ❑ My company matching gift form is enclosed.

❑ Please charge my credit card as follows: ❑ American Express ❑ MasterCard ❑ Visa

Card #__________________________________Exp Date ________________ V Code ________

Please apply my contribution to:

❑ Dance China NY

❑ School of the Arts

❑ General Support

❑ Renovation

As NYCCC is a 501(c)3 organization, your donation is deductible to the extent allowed by law