|
|
Three lines of
engraved type, 13 spaces per line, standard size brick. Donation: $50.00 YES, I would like to donate___ bricks @ $50.00 each. Total: ________ Line 1: |___|___|___|___|___|___|___|___|___|___|___|___|___| Line 2: |___|___|___|___|___|___|___|___|___|___|___|___|___| Line 3: |___|___|___|___|___|___|___|___|___|___|___|___|___| Attach a separate piece of paper for additional bricks. NAME:_______________________________________________________________________________ PHONE:_______________________________________ E-MAIL:_______________________________ Please enclose a check or money order and mail to: THE LONG ISLAND PARROT
SOCIETY Telephone (631) 957-1100
~ email: info@liparrotsociety.org |