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total donation ($):

Notes:


I will mail my donation/membership fee
to: Manifest Gallery, P.O. Box 6218, Cincinnati, Ohio

I prefer to pay electronically with credit card or paypal
a link to paypal will be provided upon submission of this form.
you do not need a paypal account to donate using a credit card using their service.

Select one of the following: (see chart below for corresponding membership benefits)

$50 donation
$100 donation
other amount (see above)

$20 Basic Membership (Sept. 2010 - Aug. 2011)
$60 NDA 2005
$60 NDA 2006
$60 INDA 2007
$60 INDA 4
$60 INDA 5***
$60 INDA 6***

$75 Manifest Short Sleeve T-shirt w/logo - visit the Manifest Gear page to see sample. Please indicate men's or women's style in 'notes'.
             Small     Medium     Large

$250 A set of Season-6 catalogs (volumes 39-47)
$300 Subscription to Season-7 catalogs
$750 Boxed set of Manifest Catalogs volumes 1-47 (first six seasons)

All premiums are a gift in exchange for support, and are offered while quantities last. Donations minus value of premium are tax deductible.
*** The INDA 5 will be available in late 2010. The INDA 6 will be available late in 2011.

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