SCHOOL OF THE ARTS FOUNDATION, INC.

P.O. Box 552 • West Palm Beach, Florida 33402-0552 • Phone 561-805-6298 • Fax 561-805-6299 • www.soafi.org
ALEXANDER W. DREYFOOS SCHOOL OF THE ARTS
2011-2012 SAVE THE ARTS CAMPAIGN
PART ONE: Please print and complete the following information: Use additional sheet, if necessary.
Student’s Name ________________________________________________________ Department ________________Current Grade _____
Student’s Name ________________________________________________________ Department ________________Current Grade _____
Parent Name (s) ____________________________________________________________________________________________________
Address __________________________________________________________________________________________________________
City/State/Zip _____________________________________________________________________________________________________
Home Phone _______________________________________________ Cell Phone _____________________________________________
Email 1 _____________________________________________ Email 2 ______________________________________________________
Mother’s Employer _____________________________________________________ Office Phone ________________________________
Father’s Employer ______________________________________________________Office Phone _________________________________
Does your employer match charitable donations?
Yes
No
Not Sure
Should we contact your employer for possible donations?
Yes
No
Name of contact ______________________________________________________Phone ________________________________________
Parents please check the boxes on the left to indicate your agreement to participate.

I understand my child’s art education program at Dreyfoos is not fully funded by the State/School District to provide a reasonable student/teacher
ratio, art supplies and equipment.

I understand that the school’s budget for the arts is supplemented by successful fundraising and parental support.

I understand that there may be additional production/performance/supply fees for which I will be responsible.

I understand my commitment is voluntary and not required for my child to attend the Dreyfoos School of the Arts.
The School of the Arts Foundation may recognize my cash donations and fundraising activities by listing my name in various programs
throughout the year.

I would like to be recognized as __________________________________________________________________________ for my contributions.

I wish that my contributions remain anonymous.
PART TWO: Contribution/Payment Plan (Please note all contributions are tax deductible and non-refundable.)
I am able to support my child/children’s arts and academic education by committing to the following gift level for the 2011-2012
School Year.

$25,000 Executive Producer
$3,000 Playwright
$500 Student

$10,000 Musical Conductor
$2,500 Musician
$100 Friend

$7,500 Choreographer
$1,000 Artist
$____ Other

$5,000 Director
PART THREE: Contribution/Payment Method

Enclosed is my check for the full amount of $ ______________________________________ payable to School of the Arts Foundation.

I will solicit contributions from private donors in the amount of $ ____________________________________________________.

The __________________________________Company/Corporation will sponsor my child with a contribution of $ ____________.
Payment Plan: My total contribution is $____________________ and will be fulfilled using the following payment plan(s):

A single one-time payment of $ ______________________ to be fulfilled by May 1, 2011

A total of three installment payments of $ ________________ will be made on or before August 1, 2011.

A total of ten monthly payments of $ ______________will be made on or before December 1, 2011.

I request to be invoiced and will fulfill my contribution by check/money order or credit/debit card according to the payment plan
selected above. Please make checks payable to School of the Arts Foundation (SOAFI).

I authorize SOAFI to automatically charge my credit card according to the payment plan indicated above. Please complete the card
information below.
Payment Type:
Visa
Master Card
American Express
Credit Card Number _______________________________________________________________________ Expires _________________
Name on Card _____________________________________________Signature _______________________________________________
If Credit Card billing address differs from the mailing address listed above, please indicate below:
Credit Card Billing Address _________________________________________________________________________________________
City State Zip+4
Parent Signature _________________________________________________________________ Date _____________________________
The School of the Arts Foundation, Inc. is a 501(c)(3) tax-exempt corporation. The Foundation’s Federal ID number is 65-0395865. A copy of the official registration and financial information may be obtained from
the Division of Consumer Services by calling 1-800-435-7352 toll free within the state. Registration does not imply endorsement, approval or recommendation by the state. Registration #CH-8773 1/03/11