Donation & Membership Form – Sherwin Miller Museum of Jewish Art

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Donation & Membership Form
Please fill out the following form. Please contact Lorri Krisman if you have any questions.
lkrisman@jewishtulsa.org
918-935-3672

- Is this a:*
  - Renewed Membership
  - New Membership
  - Gift Membership
  - Other
- Choose if applicable:
- This is a
  - Gift
  - Membership
  - Tribute
- Please choose an option below if this is a gift or investment :
  - Operating Fund
  - Endowment Fund
  - Building Fund
Please type in an amount or choose an option below.
- Amount of investment
  Please enter a number greater than or equal to 0.
  Please enter an amount or choose a membership level below.
- Membership
  - Director's Circle - $5,000
  - Benefactor - $2,500
  - Sponsor - $1,500
  - Patron - $1,000
  - Sustaining - $750
  - Suppoting - $500
  - Contributing - $250
  - Friend - $125
  - General (individual) - $50
  - Senior (individual) - $35
  - Student - $25
  - Jewish Genealogical Society-Museum membership dues plus - $18
- Membership
  - Contributing - $250
  - Friend - $125
  - Family - $75
  - General (individual) - $50
  - Senior (individual) - $35
  - Student - $25
  - Jewish Genealogical Society-Museum membership dues plus - $18
- Occassion
- Choose if applicable:
- This is
  - In honor of
  - In memory of
- In honor/memory of:
  First Name Last Name
- From :
  First Name Last Name
- Address
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Phone
  Phone
- Who should be notified :
  First Name Last Name
- Address
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Phone
  Phone
- Total Donation*
  Price: $0.00
- Credit Card
  
  American Express
  Discover
  MasterCard
  Visa
  Card Number Expiration Date Security Code Cardholder Name

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