St. Paul's Episcopal Church Exton

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

St. Paul's Altar Flowers donation form

Please fill out this form if you wish to donate the Altar Flowers in the remembering of a loved one or to celebrate life's milestones for a donation of $65.

Donation Amount

Given by:

Phone:

Email:

Name(s) of those to be remembered:

Wording:

Donor 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: *