Please print, complete and mail this form with your check payable to The Woodrow Wilson Center to
The Woodrow Wilson Awards
Adrienne Arsht and José Cancela, Co-Chairmen
Post Office Box 415037
Miami Beach, FL 33141.
VISA and MasterCard accepted - see below!

  We would like to be a Patron. Please find our enclosed              contribution of $15,000
  We would like to be a Benefactor. Please find our             enclosed contribution of $10,000
  We would like to purchase a Corporate Table (of 10)             for $5,000
  I will be attending. My contribution of $250* per person            is enclosed.
  I will not be able to attend, but enclosed is my tax             deductible contribution of $                 .

NAME         ____________________________________________
                
COMPANY:                                                                                                 

TEL:                                                   FAX:                                                 

E-MAIL:                                                                                                       

CHECK ENCLOSED FOR: $ ____________

CREDIT CARD:         VISA   MasterCard

CARD #                                                           EXP. DATE ___/___/___

SIGNATURE:                                                                                                 

Please list the names of members of your party separately.

Contributions to The Woodrow Wilson International Center for Scholars are partially tax deductible for federal income tax purposes. For questions, please contact Margueritte Ramos & Associates, Inc., P.O. Box 415037, Miami Beach, FL 33141. Phone: (305) 864-7444. Fax (305) 861-2793. *$250 minus the cost of the dinner per person, is tax deductible.