Enclosed is my Tribute Gift of $_____________________________

Please Circle One:
In Memory of
In Honor of
On the Occasion of    ______________________________________________

Please direct this gift to Bellingrath Gardens and Home’s (please circle one):
Endowment Fund
Operating Fund

Tribute Wording:   ___________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Please send gift acknowledgement* to: 

Name:  ______________________________________________     
Address:  ______________________________________________
City: ______________________________________________State:__________    Zip:__________

* Amount will not be disclosed.

This Tribute Gift is from:
Name:  ______________________________________________     
Address:  ______________________________________________
City: ______________________________________________State:__________    Zip:__________
Telephone:  ______________________________________________
Email:______________________________________________

Method of Payment:
Check (Made payable to Bellingrath Gardens and Home)
Visa
Mastercard
American Express
Mastercard

Card Number: ______________________________________________
Exp. Date: ______________________________________________

Signature: ______________________________________________

Please complete form and send payment to:

Membership Office
Bellingrath Gardens and Home
12401 Bellingrath Gardens Road
Theodore, Alabama 36582
251.973.2217 extension 165
Fax: 251.973.0540
www.bellingrath.org