Archbishop Wood High School

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Archbishop Wood High School
Alumni Prayer Garden Stone Paver Order Form
$175.00 each

Qty

Description

Amount

Total

Alumni Prayer Garden Stone Paver

$175.00

I would like to help decrease expenses by paying for the 3% credit card fee.

Total: $175.00

The Alumni Prayer Garden Stone Pavers measure 9.5” x 6”. Please list below the names, dates, organizations etc. exactly as you wish for them to appear on your stone. IMPORTANT: Each line has a maximum limit of 15 characters per line.

Line 1:

15 characters

Line 2:

15 characters

Line 3:

15 characters

Customer Information

First Name: *

Last Name: *

Maiden Name
(if applicable):

Phone: *

Email: *

Payment 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: *

Phone: *

Email: *

A receipt will be emailed to this address.

I am a Wood Graduate (fill in Class Year below)

Class Year:

I am a Wood Parent of (Name of Student):

Student Class of:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *