Donation Form

Name*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number:*

Area CodePhone Number
Donation Options*
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Amount$10.00

Quantity

Amount$25.00

Quantity

Amount$50.00

Quantity

Total $0.00
* To make monthly donations and other amounts not listed above, please use:

Otherwise proceed below.
By clicking the "Pay Now" button you are submiting your online application and will be re-directed to Paypal to submit your payment. Once we recieve your payment, we will contact you about your Membership.

Thank you!
You can also complete this page, print it out and mail it with a check made payable to: Stamford Art Association, 39 Franklin Street, Stamford, CT 06901.
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