I ___________________________________________________________, hereby pledge $10,000 (Ten thousand dollars) to the Economic Club of New York on the occasion of the Centennial Anniversary of the Club.
Payment will be made by check payable to The Economic Club of New York, or
Credit Card: Visa _____ Mastercard _____ American Express _____
Card Number: _________________________________ Expiration Date: ________
or the transfer of securities, by ______________________________________ 2016.
Please contact the Club office for information regarding transferring securities. Contributions will be fully tax deductible to the extent provided by law.
The Economic Club’s Federal ID # is 13-1655225
____________________________________ _________________________
Signature Date
Name: _____________________________________________________________
Address: ___________________________________________________________
____________________________________________________________
____________________________________________________________
Phone: ________________________ E-Mail: ______________________________
Please return the completed form to:
The Centennial Society
The Economic Club of New York
350 Fifth Avenue, Suite 4910
New York, NY 10018
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