2018 Palace Theatre Donation Form Palace Theatre Donation Form If you are human, leave this field blank. Your First Name * Your Last Name * Email * Mailing Address * City * State * Zip * Donation Amount * Please make my gift in honor or memory of: Please Make A Selection Below: In Honor of: In Memory of: First Name Last Name Send acknowledgement to: We will promptly acknowledge your gift and send an appropriate note to the person indicated above. The amount of your gift will not be mentioned. Prove you are a human. Please click the box above to prove you are a human.