Rose City Renaissance Membership Campaign I/we want to build a more vibrant downtown Norwich by becoming a member of Rose City Renaissance. Check your member level: Basic Membership Individual — $30 Family — $50 Business — $125 Premier Membership Bronze Patron — $250-$499 Silver Patron — $500-$999 Gold Patron — $1,000 and above VISA/MC/AmEx/Discover — Expiration Date: _________________________________ Account Number: ______________________________________________________ Check enclosed for: $___________________________________________________ (Make checks payable to Rose City Renaissance.) Name/Business Name: __________________________________________________ (As you wish it to appear in our Member Roster.) Street Address: _______________________________________________________ City: ___________________________________ State/Zip: ____________________ E-Mail: _____________________________ Phone: __________________________ My membership gift will be matched by: ____________________________________ (Please enclose Matching Gift instructions.) Mail To: Rose City Renaissance 77 Main Street Norwich CT 06360