Donation Form

Enter Your Information

Name

First Last

Email(Required)

Phone

Address

Street Address City State / Province / Region ZIP / Postal Code

Choose Your Donation

Donation Amount	Level	Description
$25 - $99	Museum Level	Name will be listed with others in no particular order on a stylish panel next to the butterfly wall.
$100 - $249	Supporter Level	Small Butterfly, includes two lines of text
$250 – $499	Curator Level	Medium Butterfly, includes two lines of text
$500 - $999	Patron Level	Large Butterfly, includes two lines of text
$1000 - $4999	Director Level	Sunflower, includes three lines of text
$5000 +	Benefactor Level	Larger Sunflower, includes three lines of text

Enter Your Donation Amount:(Required)

Please enter a number greater than or equal to 25.

Choose where your contribution will be used:(Required)

Betterment of the Museum

Dacotah Prairie Museum Foundation Scholarship for Brown County Students

Traveling Exhibits

SPECIAL PROJECT: Railroad Exhibit Update

Select one before confirming amount:(Required)

I want to donate and participate in the DPM’s donor recognition display

I only want to donate and not participate in the DPM’s donor recognition display (donor will still be listed in print where customary, ie: annual report)

I want to remain anonymous (to not appear in print or in recognition)

I want to remain anonymous but honor someone in the DPM’s donor recognition display

Choose the text as you would like it to appear on our donor recognition wall.

Skip this part if you choose to not participate in the donor recognition display, thank you.

Pending admin approval

Examples

In honor of
Uncle Jim Kehler
The Jensen Family
Larry, Becky, Jayden & Darla
Always in our hearts
Gramma Jo
Love, Sara & Dylan

Line One (for all amounts)

Line Two (for $100+ amounts)

Line Three (for $1000+ amounts)

Review Your Selections

Donation Amount

Price: $0.00

Contribution Selection:

{Choose where your contribution will be used::4}

Recognition Selection:

{Select one before confirming amount::5}

Donor Recognition:

{Line One:6}
{Line Two:8}
{Line Three:7}

Please make sure to verify your spelling

Process Payment

Donation Amount:

Credit Card

Butterfly Campaign

Enter Your Information

Choose Your Donation

Examples

Review Your Selections

Contribution Selection:

Recognition Selection:

Donor Recognition:

Process Payment

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