Give to the RSO

Donation/Pledge Form

* indicates required infomation

* This Gift or Pledge is for:
The Roanoke Symphony The New River Valley Friends of the Roanoke Symphony

* First Name: * Last Name:
* Address:
* City, State & Zip:
Phone (day):
Phone (eve):
* Email Address:
Gift to Annual Fund:

Gift Circles

up to $499: Contributor
$500 - $999: Patron
$1000 - $1499: Benefactor
$1500 - $2499: Bravo
$2500 - $4999: Concertmaster
$5000 - $9999: Conductor
$10000 - $19999: Founder
$20000 - $49999: Gold Baton
$50000 + : Platinum
$50 $500 $1500 Other Amount:
$100 $750 $2500  
$250 $1000 $5000  
Gift to Challenge Grant:
$50 $500 $1500 Other Amount:
$100 $750 $2500  
$250 $1000 $5000  
The above checked amounts are:
Contribution, my payment information is below.  
Please recognize me in the RSO program guide as follows:
I wish to remain anonymous -- do not list my name.  
By checking this box, I wish to waive donor benefits from the RSO.  
Payment Options
Please charge my credit card the full amount.
Please charge my credit card in the following installments.
amount date    
Payment Information
* Credit Card Type:  
* Credit Card Number:     * Exp.Month: * Exp.Year:
* Security number
(This is the three-digit number on the back of your card).
* Name as it appears on your Credit Card:
Billing Address (if other than above):
City, State and Zip (if other than above):
My employer will match my gift.  
Company Name:
Anticipated Match Amount:
Please submit matching gift form to the RSO or use the method as required by your employer.

I have included the Roanoke Symphony in my estate plans.
I would like more information on making a planned gift.

After you submit this form, you will see a short message of thanks, and you will also receive a confirmation by mail within just a few days. In the meantime, if you should have questions about your donation, please contact Development Director, C. W. Markham at (540) 343-6221 extension 225, or email