GCCCA 2010-11 Membership Form

To help support the full cost of our concert series and our Educational Outreach program for school children, please consider augmenting your membership payment with a  tax-deductible donation. DONOR PLANS:
___	New	__	Student(s)	@$15	_____	___	Friend	$40
___	Renewal	__	Adult(s)	@$45	_____	___	Patron	$70
		__	Early Bird(s)	@$40	_____	___	Benefactor	$130
			(if received by 6/30/10)			___	Sponsor	$240
						___	Sustainer	$350
						___	Angel	$500
			Membership Total		_____	___	Other	______
			Donation		_____
			Total Enclosed		_____

Children of members (up to age 17) are admitted free of charge.

Name _______________________________              Telephone ___________________

Address _____________________________              City/State/Zip ________________

E-Mail ______________________________              Check #_______

Make checks payable to GCCCA

Mail to: P.O. Box 2722, Silver City, NM 88062         Sold by________   

(Tickets will be mailed in early September.)

    Phone: (575) 538-5862   e-mail: gccca@gcconcerts.org  Web addr.: gcconcerts.org