Diocese of Lake Charles

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

It is our desire that the serene refuge found within the Saint Charles Center Memorial Courtyard will deepen one’s spiritual awareness, provide renewal, and the opportunity for rediscovering life’s meaning in quite reflection. Thank you for your wonderful donation.

Purchase a Brick:

Qty

Description

Amount

Total

4” x 8” Brick

$100.00

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8” x 8” Brick

$250.00

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I would like to make a monetary donation:

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Total: $0.00

Indicate what you would like to include in the engraving:

Brick One
4” x 8” (up to three lines/20 characters per line/60 characters total including spaces)

Line #1:

Line #2:

Line #3:

8” x 8” (up to six lines/20 characters per line/120 characters total including spaces)

Line #1:

Line #2:

Line #3:

Line #4:

Line #5:

Line #6:

Brick Two
4” x 8” (up to three lines/20 characters per line/60 characters total including spaces)

Line #1:

Line #2:

Line #3:

8” x 8” (up to six lines/20 characters per line/120 characters total including spaces)

Line #1:

Line #2:

Line #3:

Line #4:

Line #5:

Line #6:

Brick Three
4” x 8” (up to three lines/20 characters per line/60 characters total including spaces)

Line #1:

Line #2:

Line #3:

8” x 8” (up to six lines/20 characters per line/120 characters total including spaces)

Line #1:

Line #2:

Line #3:

Line #4:

Line #5:

Line #6:

Payer Information:

First Name: *

Last Name: *

Company 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: *