University of Rochester - MAG - Membership as Gift

Use the form below to send a gift of a Memorial Art Gallery Membership.

Please note: Gift recipient name and mailing address fields are required.

Recipient’s Name:
(first & last) Required Field

Second Recipient's Name
(first & last if applicable)

Recipient's Phone Number: Required Field

Recipient's Email Address:

Recipient's Street Address: Required Field

Recipient's City: Required Field

Recipient's State: Required Field

Recipient's Zip: Required Field

Membership Delivery Preference: Required Field

Would you like us to include gift packaging? Required Field

My Personal Information

Title: (Mr., Ms., etc.) Required Field

First Name: Required Field

Last Name: Required Field

Suffix:

Email:

Email

Phone number format: XXX-XXX-XXXX

Primary Phone Number: Required Field

Phone Type: Required Field

My Home Address

Street Address: Required Field

Street Address Line 2:

City:

State:

Home Zip Code: Required Field

Gallery Membership

Membership Amount: Required Field

$

Designations

Designations Select Membership Level

Selected Designations

Remove	Name	Amount	Percentage
	Benefactor	$	%
Total:	$0.00	0%

Is this a new membership or are you renewing an existing membership? Required Field

Membership ID Number:
(if renewing)

This field is not required for renewal. Please complete only if you have the information available.

*Gallery memberships are non-refundable and non-transferable. Membership benefits are subject to change.
**Gifts to the University of Rochester Memorial Art Gallery are deductible for income tax purposes to the extent provided by law. Please consult your tax adviser.

Gift of MAG Membership