Art Gallery of Western Australia Foundation

Additional Pledge Form

The focus of the Foundation is to build your State Art Collection and support exhibitions and
programs through Foundation membership.

You have the opportunity to be involved in securing the future.

Name:

I wish to support the Art Gallery of Western Australia Foundation by making an additional pledge:

Amount $____________

I wish to direct my donation to:

Wherever the need is greatest

Corsini Exhibition

Contemporary Art

Historical Art

Aboriginal and Torres Strait Islander Art

Education and Public Programs

Contributions may be made over a period of up to five years.

My contribution will be made in the following manner:

One payment of $ in full by

OR Annual Payment of $

Number of Payments

Total $

Beginning

Cheques should be made payable to the Art Gallery of Western Australia Foundation.

OR I prefer to pay by credit card:

Please charge $

Visa Mastercard

Card No. / / / Expiry date: /

Name on Card:

Signature Date / /

Please acknowledge my contribution in the name(s) of:

ALL GIFTS ARE TAX DEDUCTIBLE