UC JAZZ ENSEMBLES
FALL 2009 FUNDRAISER 
ADVERTISER AND DONOR RESPONSE FORM

Please complete and return to UC Jazz Ensembles, 72 César Chavez Student Center #4280, UC Berkeley, Berkeley, CA  94720-4280 by November 6, 2009.  Questions?  Please call Carol Suveda at (510) 643-2662.

YES, I/We would like to support the Fall 2009 Fundraiser by purchasing the following ad space in your program (please check which):

___      1/8 page (2 1/4” wide by 2” tall)                       $50
___      1/4 page (2 1/4” wide by 4” tall)                       $100
___      1/2 page (5” wide by 4” tall)                             $250
___      Full page (5” wide by 8” tall)                             $500

___      Enclosed is my camera-ready art.

YES, I/We would like to support the Fall 2009 Fundraiser with a tax-deductible donation of (please check which):

___ $25           ___ $50           ___ $100         ___ $250         ___ $500         ___ $_______
                                                                                                                                    other

Name __________________________________________________________________

Address ________________________________________________________________

City, State & Zip _________________________________________________________

Daytime Phone __________________________________________________________

Email __________________________________________________________________

___  Enclosed is a check payable to UC Regents – UC Jazz Ensembles.

___  Please charge my  __ MasterCard  __ VISA  __ AmEx  __ Discover card
Account #________________________________ Expiration Date _________________

UC JAZZ ENSEMBLES APPRECIATES YOUR SUPPORT!
Our Tax ID # is 94-6002123