P.O. Box 219233 · Portland, OR 97225 · 503-222-3284 ·
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Donation Form
Whether donating by mail or electronically, please fill out this form and either email it to or mail to:
Blueprint
P.O. Box 219233
Portland, OR 97225
Donor Information
Name:
Address:
City, State, Zip Code:
E-mail:
Phone:
Filling in your e-mail and/or telephone number is optional, but will allow us to contact you with any questions regarding your donation and will only be used for this purpose (see Privacy Statement below).
Donation Amount:
Dedication, Message, or Other Comments:
Do you wish to make this donation anonymously? (Yes/No):
Levels of Donation
Director’s Circle $5,555+
Singers’ Circle $3,500-$5,554
Topaz Circle $2,000-$3,499
Garnet Circle $1,000-$1,999
Benefactor $500-$999
Patron $250-$499
Friend $100-$249
Contributor Up to $99
All named donation level contributors are listed on the organization’s website, as well as on concert programs.
Blueprint is a non-profit organization organized under section 501(c)(3) of the Internal Revenue Code, or corresponding section of any future federal tax code. Donations are deductible for income-tax purposes
Privacy Statement
Any individual data collected will only be accessible by the Blueprint organization. We are a non-profit organization that does not procure individual data for sale to third parties. We respect the fact that your personal data is valuable to you, and believe no one has the right to attempt to sell or broker information in exchange for donations or requests for information on our organization or mission statement, or any other material.
How to Donate Stock
A charitable gift of stock provides an opportunity for tax savings while generously supporting Blueprint. Electronic delivery of stock shares is the most secure and expedient delivery process available and provides efficient internal control as well as cost savings. However, you may also transfer certificates directly.
Notification of Donor Intent
Regardless of the method chosen to deliver a gift of stock, the donor or the transferring broker must, for audit and acknowledgement purposes, provide the following information:
• Donor’s name and complete address
• Name and number of securities transferred
• Broker’s name and complete address
You can send your stock certificate(s) directly to Blueprint. Mail your unendorsed certificate(s) and stock power form via Registered Mail (we recommend that you send the certificate(s) via Registered Mail), in separate envelopes to:
Blueprint
P.O. Box 219233
Portland, OR 97225
Enclose a copy of the above Donation Form to communicate this information at time of transfer. Also include a copy of the form below:
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Stock Donation Form
Securities Gifted
Date of Transfer:
1. Number of Shares:Name of Security:
2. Number of Shares:Name of Security:
3. Number of Shares:Name of Security:
Transferring Broker
Name:
Address:
City, State, Zip Code:
E-mail:
Phone:
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Owner / Donor (please print)Owner / Donor (please print)
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Signature of Owner / DonorSignature of Owner / Donor