Yankee Institute for Public Policy P.O. Box 260660 Hartford, CT 06126-0660 (860) 297- 4271 info@yankeeinstitute.org Yes! I want to participate in the Yankee Institute Tie-In! I will donate $100 for each Vineyard Vines® tie, as follows: Yellow Tie - # of Ties 0 - $00 1 - $100 2 - $200 3 - $300 Red Tie - # of Ties 0 - $00 1 - $100 2 - $200 3 - $300 I would like to make the following additional contribution: $ *Here is my total contribution amount (minimum $100): $ Please fill out the following information in order to complete your donation. Use your tab key to move to the next field. Note that all fields marked with a red asterisk ( * ) are required. *Title Mr. Ms. Mrs. Miss *First Name *Last Name Company *Address Address *City *State/Province *Zip/Postal Country *Phone Number *E-mail Address *Please select a card type. Visa Mastercard *Credit Card #  *Expiration Date  January February March April May June July August September October November December / 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015    The Yankee Institute for Public Policy is an IRS-recognized 501(c)(3) non-profit organization. The tax-deductibility of charitable contributions are reduced by the fair market value of items that you receive. The fair market value of the Yankee Institute tie is $30. You should consult with a tax professional to determine the proper tax treatment of your donation. Please rest assured that your personal information will be kept completely confidential and will not be shared with any third-party except those necessary to complete the transactions authorized on this form.