Rialto Community Theatre, Inc.

P.O Box 874, Deer Lodge, MT 59722,  www.deerlodgerialto.com

Restoration and rebuilding the historic Rialto Theatre is more than a dream, and you can help bring back our cultural center with your tax-deductible contribution.

Federal Tax ID# 81-0503522

I/we wish to donate the following amount to the Rialto Restoration Fund:

 $25__ $50__ $100___ $250___

$300/ea____ for ____SEAT(S)   $500___ $1,000___ $2,500___ $5,000___Other___

     Amount Enclosed_____   Pledged for 2011____   Pledged for 2012______

 Name________________________________________ Phone_______________

Mailing Address______________________________________________

______________________________________email__________________________

  Thank you for your help.  Some businesses match employee contributions to non-profits.

This donation is in memory of ____________________________________________________

OR This donation is in honor of___________________________________________________

Please notify _________________________________________________________________

Address:_____________________________________________________________________