Donations

I Want To Make a Contribution

Please fill out the form below which will constitute a pledge to pay.
A check or money order should be made out to "The Chrysalis Project".

Please send to: Venice Public Art Walls - c/o The Chrysalis Project 2554 Lincoln Blvd. #162 Venice, CA 90291

First Name:*		Last Name:*
Email Address:*		Company or Organization:
Mailing Address:		City:
State or Province:		Zip or Postal Code:
Phone #1:		Phone #2:

Contribution Levels:

	Contributor $.01-$9.99		Advocate $300-$999
	Catalyst $10-$49		Guardian $1,000-$2,499
	Supporter $49-$149		Patron $2,500-$4,999
	Sustainer $150-$299		Legacy $5,000-$10,000+

Specific Amount:

I would like to pledge this amount.

Contribution Details:

	I would like my donation to be unrestricted and to be used where most urgently needed.
	I am making a substantial contribution and would like to fund a specific program.
	I would like to make an in-kind contribution of goods or services. I understand that I need to discuss the value of this contribution with ICU Art.

Contribution Area:

I would like my donation to be used in the following area:

I wish this contribution to be listed under:

	my name, my company name, in the name of , Anonymous.
	I wish to be associated with a specific level of giving.
	I wish to be recognized as an "Unspecified" donor.
	I would like a receipt for my donation sent to me via e-mail.

*required

For any questions or proposals, you may contact ICU Art directly at development@veniceartwalls.com or
call Stash Maleski, Director of ICU Art at (310) 309-7756.