Count on my support to leave a legacy…

BERNIE POWERS BAND FOUNDATION DONATION FORM

Please print and submit with your donation to: 
Bernie Powers Band Foundation, P.O. Box 183, Sun Prairie, WI 53590

Thank you for your support!

Please accept my enclosed gift:

_____ $50    "Friend"

_____ $100   "Section Leader"

_____ $500   "Drum Major"

 _____ $1,000  "Director"

_____ Other: ________________

Please designate how you would like your donation to be  used:

_____  Music Mentors  

_____   Music Scholarships (select: Paris Music Scholarship -- Jack Bogle Music Education Scholarship -- 
                            Jeff Bogosh Summer Jazz Camp Scholarship -- Marcia Berman SOSP / Percussion Scholarship)

_____   Music Advocacy

_____   Principal Endowment


In memory of / In appreciation of  / On behalf of: ________________________________

Your Name: ________________________________________________________

Address: ______________________________________________________

City:__________________________________________    State:_________

ZIP Code:__________    

Email:_________________________________________________________ 


Method of Payment...      _____ Enclosed Check      _____ Bill me   

Please make your check payable to BPBF, Inc. 

We are a 501 (c)3 organization. Your donation is tax deductible.