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Print this form and mail or fax it with payment to: China Institute, 125 East 65th Street, New York, NY 10021-7088 USA, Fax: 1-212-628-4159
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Yes! I'd like to join China Institute
one year
two years (Plus 1 extra month)
three years (Plus 3 extra months)
General Membership
Individual Membership $55 ($40 tax deductible)
Dual/Family Membership $95 ($65 tax deductible)
Special Memberships
Friends of the Gallery
Friend (Pengyou) from $1,500 ($1,300 tax deductible)
Sponsor from $2,500 ($2,300 tax deductible)
Leader from $5,000 ($4,725 tax deductible)
Patron from $10,000 ($9,725 tax deductible)
Benefactor from $25,000
Young Associates $100 ($40 tax deductible)
China Institute Women's Association $55 ($40 tax deductible)
Renwen Society $55 ($40 tax deductible)
Supporting Memberships
Red Envelope $250 ($200 tax deductible)
Silk Purse $500 ($440 tax deductible)
Jade Box $1000 ($900 tax deductible)
Scholar’s Circle $2,500 ($2,300 tax deductible)
Corporate Membership
Corporate Sponsor $2,500
Corporate Leader $5,000
Corporate Patron $10,000
Corporate Benefactor $25,000
Mr. Mrs. Ms. Miss Mr. and Mrs.
Name ____________________________________________________________
Street __________________________________________________Apt.____
City _____________________________________ State ___ Zip ________
Phone(home) _____________________ (work) ________________________
Fax _____________________________ Email _________________________
I have enclosed my check, payable to:
China Institute in America
Or charge my Visa MC AmEx Discover
Number _________________________________ Exp. Date _______________
My employer has a matching gift program that will increase my
support to China Institute. I have enclosed my company's form.
This is a gift membership.
The name on the membership card should read:
___________________________________________________________________
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