Friends of Karen - Acceptiva

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

8" x 8" Brick

Tax Deductible Contribution
Customized with 5 lines of text
(20 characters per line including spaces)
ANY SYMBOL IS CONSIDERED ONE SPACE
(PERIOD, COMMA, DASH).
ALL TEXT IS CENTERED

Qty

Description

Amount

Total

8" x 8" Brick

$1,000.00

$1,000.00

Replica brick with the same message

$16.95

$16.95

I would like to pay the 3% credit card processing fee so that Friends of Karen receives my full contribution.

Brick Information

Line 1:

Please only 20 characters per line including spaces.

Line 2:

Please only 20 characters per line including spaces.

Line 3:

Please only 20 characters per line including spaces.

Line 4:

Please only 20 characters per line including spaces.

Line 5:

Please only 20 characters per line including spaces.

Clip Art:

Tribute Information

Making a gift in honor or in memory of a special person is a wonderful way to recognize them and provide hope and comfort to others. If you would like, we will send a letter to a recipient of your choice informing them of your thoughtful gesture.

Tribute Type:

Full Name of Honoree:

If you wish us to send a notification letter, please provide the following recipient information.

Salutation:

Name:

Address:

Address 2:

City:

State:

Zip Code:

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *