Donation Form

* Required Fields

Donation Information

Amount

$500

$250

$50

Other (min $5)

Type of Donation

One Time Donation
Recurring Donation

Frequency

Contact Information
* First Name
* Last Name
Company Name
* Address
Address 2
* City
* State/Province
Country
* Zip/Postal Code
Home Phone
Cell Phone
Work Phone
* Email (for sending tax letter)

Credit Card Information
Card Holder Name

Card Account Number
Expiration Date
* Security Code The 3 or 4 digit Security Code (CVV2) can be found on the back of your credit card. For American Express, the Security Code (CID) can be found on the front of the card.

Billing Address
Same As Above
* Address
City
State/Province
* Zip/Postal Code
Email

Privacy Policy
We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.

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A copy of our most recently filed financial report is available from the Charities Registry on the New York State Attorney General’s website at www.charitiesnys.com or, upon request, by contacting the New York State Attorney General, Charities Bureau, 28 Liberty Street, New York, NY 10005, or us at 4140 Broadway at 175th, New York, NY 10033. You may obtain information on charitable organizations from the New York State Office of the Attorney General at www.charitiesnys.com or (212) 416-8400.

United Palace of Cultural Arts (UPCA) •• 4140 Broadway at 175th, NY, NY 10033 •• Mail to P.O. Box 1168, NY, NY 10040 •• 212-568-1157 •• [email protected]