Bonk Festival of New Music
2004 Membership Campaign

I'd like to be a:

Friend of Bonk ($25 and up) receive the Bonk newsletter and festival updates
Bonk Ally ($100 and up) receive 2 Bonk T-shirts the Bonk newsletter and festival updates
Bonkefactor ($500 and up) receive a full pack (7) of Bonk CDs, invitation to special events/receptions, plus Bonk newsletter and festival updates

Mr.
Mrs.
Ms.
_____________________________
First Name		  _____________________________
Last Name
Mailing
Address
__________________________________________________________
Street
 
___________________________________________
City, State		 _______________
Zipcode
Telephone
_________________________
Circle: home/work/mobile		  _________________________
Fax
Email
___________________________________________________________
Employer
___________________________________________________________
For matching gift purposes
Amount
of Gift
$ ________________   Please make checks payable to Bonk Inc.
Payment
Method
Payment in full is enclosed I would like to make (monthly/quarterly) payments of $ ________ each.

Print this form and mail it to:
Bonk, Inc.
407 W. Frances Ave.
Tampa FL 33602
A copy of the official registration and financial information may be obtained from the Division of Consumer Services by calling 1-800-HELP-FLA (800-435-7352) toll-free within the state. Registration does not imply endorsement, approval, or recommendation by the state.