Richard Jay Simon Artistic Director		HONORARIUMS & MEMORIALS HONORARIUM GIFTS What gift do you possibly get for the friend or family member that has everything?  Consider making donations to Mosaic Theatre in their honor and acknowledge their special days: Birthdays, Anniversaries, etc.  It's simple.  Fill out the form below and we will send you a receipt for your donation and them a letter stating that a gift has been made in their honor.  We'll keep the amount our secret unless you tell us otherwise. MEMORIAL GIFTS If you would like to remember someone who loved Mosaic Theatre during his or her lifetime, you can make a gift in that person's name. You will receive a receipt for your donation and we will write to the family members or friends notifying them that you have made a very thoughtful gift in memory of their loved one.  Again, we will keep the specific amount confidential unless instructed otherwise. 1. Please complete the name and address section below Name Address City/State/Zip Telephone E-mail I wish to remain anonymous.     2. Your purchase Please select one Honorarium Gift Memorial Gift I wish to donate Select Amount $25 $50 $100 $200 $500 $1,000 Other In honor of Total Amount Due Special Instructions 3. Your payment I am sending a check made payable to Mosaic Theatre      12200 West Broward Blvd., Plantation, FL 33325 Please bill my credit card Visa    Mastercard    Discover    Amex Name On Card Card Number Exp. Date JAN FEB Month MAR APR MAY JUN JUL AUG SEP OCT NOV DEC   Year 2008 2009 2010 2011 2012   MAIL TO MOSAIC THEATRE, 12200 West Broward Blvd., Plantation, FL 33325 PHONE (954) 57-STAGE (78243)        FAX (954) 473-4713
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		American Heritage Center for the Arts, 12200 West Broward Boulevard, Building 3000 Plantation, Florida 33325,  phone: (954) 577-8243