YES!  I want to keep Mary Emery's Dream Alive!

Name: _______________________________________________                  Tel.No. _______________________

Address: ____________________________________________________________________________________________

Email address: (MPF use only - for updates and news) _______________________________________________________

Membership Levels

* $20 Carillon (Individual)          

* $35 Family Statuary              

*    $50 Pavilion              

*    $100 Concourse  (Concourse Level Contributors will receive a Mariemont collectible print)     

* $1,500 and up - Mary Emery Club Lifetime Member 

     (can be given in payments of $700 over two years: Lifetime Membership status is attained after second donation)

Lifetime members will receive a gift of either John Ruthven's limited edition print "Mariemont Cardinals" or a set of thee decorative "Mariemont Plates"

I wish to receive * The Mariemont Cardinals Print * Set of three decorative plates

*      Please send me information about remembering MPF in my Will.

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Please print and return this form with your donation to:

    Mariemont Preservation Foundation, 3919 Plainville Road, Cincinnati, Ohio 45227

Please make checks payable to "Mariemont Preservation Foundation"

Your Donation is TAX DEDUCTIBLE