Donation Form

Upon submitting the form below, you will be contacted by the LA Winds. Payment will only be processed upon selecting “I would like to proceed NOW” option.

Name *

First

Last

Email *

Company Name

Address

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Donation Options *

• Please contact me about a donation.
• I would like to proceed NOW using my credit card or PayPal account.
• I prefer to send a check payable to "LA Winds" (22647 Ventura Blvd., #590, Woodland Hills, CA 91364).

Donate NOW choices below: *

• Quartet - $25.00
• Quintet - $50.00
• Band - $75.00
• Symphony - $100.00
• Other - $0.00

Other - Specify Donation Amount

Minimum Price: $10.00

Please accept this donation *

• In Honor of ....
• In Memory of ...
• Without a specified individual.
• With another designation.

Donation specification details below:

Unless otherwise requested below, in appreciation of support for the LA Winds, all donors are named in our concert program.

• I would prefer my name NOT to be listed with the donors in the concert programs.

Comment or Message

Select Payment Option *

PayPal CheckoutCredit Card

Card Number

Expiration Date

Security Code

Card Holder Name

Website

Submit

66331