Historic Tennessee Theatre Foundation · 612 Campaign Commitment Form

Name *

Prefix

First Name

Last Name

Suffix

Partner/Spouse Name (optional)

First Name

Last Name

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone *

Email *

Verify Email *

How did you hear about the 612 Campaign? *

Are you interested in learning about donor recognition opportunities (Starting at $100,000) *

Giving Schedule

Your campaign gift can be fulfilled through one payment or recurring payments. All commitment payments are due by December 31, 2026 and recurring payments will be ended by that date. Please indicate below how you wish to give. If you wish to set a different giving installment schedule, please contact Matthew Fisher at mfisher@tennesseetheatre.com.

Total Campaign Commitment Amount *

Please enter your total planned commitment here.

Installment Number of Years *

You may spread your gift over multiple years by creating a Campaign Commitment. By selecting to span your gift over 2 years, you are committing to donate your selected amount in 2024 and again for one or two recurring years on the same gift date. We will contact you when your installments are due.

Requested Installment Start Date (Between 6/1/24 and 12/31/24) *

Please choose your first gift installment date (any additional installments will fall on this date in their respective year).

Recognition

The Tennessee Theatre may recognize your gift publicly. Please indicate how you wish your gift to be recognized.

Recognition Name(s)

Please type exactly how you wish your name(s) to appear in official recognition opportunities (ex. Mr. Marq E. and Dr. Smith)

Anonymous?

I / We wish to remain anonymous, with no mention of this campaign gift in any public manner, permanent or temporary.

Please mark my gift as anonymous.

Establish gift in

honor of

memory of

Honor/Memory of

Please list the dedicatee's name.

Person to be notified

Please list contact's full name and mailing address