Bellingrath Tribute Form

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