Rockstar Sustaining Donor Form

Sustaining Donor Form

Please fill out this form, and we will send you a separate email to set up a recurring donation. Questions can be sent to indymusicmn@gmail.com.
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Monthly Donation Amount
US Dollars
Preferred Date of Withdrawal
Example: 1st of each month
*You will receive an email from an IMCCM representative with instructions of how to set up the recurring donation within 1-5 days.

Thank you! You are a rockstar!
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