Please print this form and send it along with your donation to:
Music Maker relief Foundation, Inc
Premiums available for your tax-deductible donations:
Donation (no premiums, entirely deductible). All donations of $20 or more include one year subscription to M.M.R.F. newsletter.
16" x 20" reproduction of photograph of David Johnson's hands by Axel Kustner (quality suitable for framing). $20 Photo reproduction ($15 tax deductible).
Willa Mae "The Snake Lady" Buckner Tee shirts $25 each ($15 tax deductible), sizes L and XL (circle size)
Guitar Gabriel, Vol 1, A Living Past and Came So Far CDs $25 each ($15 tax deductible), $45 for two ($25 tax deductible), $65 for three ($35 tax deductible) includes one year subscription to M.M.R.F. newsletter. (Circle CD of choice)
Captain Luke art. One of a kind ashtrays, hand crafted from recycled aluminum cans and other found materials. $100 or more ($75 tax deductible).
Hand painted Guitar Gabriel necktie by outsider artist Sam McMillan of Winston-Salem, North Carolina. $250 ($200 tax deductible).
Captain Luke art. One of a kind cars, hand crafted from recycled aluminum cans and other found materials. $1000 or more ($900 tax deductible).
Total Donation:__________________ (no charge for shipping in US, International donors please add $5 US)
Note: due to IRS regulations the entire amount of a donation is reduced by the retail value of premiums received by donors.
Telephone (optional):__________________________(day or eve,
If you would like to make your donation by Mastercard or Visa you
Mastercard / Visa (circle one) #___________________________
Or send check or money order to:
Music Maker Relief Foundation, Inc., 4052 Summer Lane, Hillsborough, NC 27278
Email: firstname.lastname@example.org Tel:919 643 2456 Fax:919 643 2597