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I
would like to sponsor a piece of playground equipment: |
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____________________________________ $______________________ |
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Playground
Item (Click here to see
list) Price
of Equipment |
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How
would you like your plaque to read? (If
not filled out we will include standard text.) |
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I
would like to buy _______# of Pickets at $25 each.
Total
cost for Pickets = $______________________
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Personalized:
_________________________________________________ |
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(Engraving
may be 1 line, Up to 20 characters.) |
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I
would like to make a donation to the Playground-Raising
Project.
Amount
of Donation $_________________________________________________
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IMPORTANT:
Please provide a phone number below so that we may
contact you with any questions. |
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NAME:
___________________________________________________________
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COMPANY
NAME: _________________________________________________ |
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ADDRESS:
_______________________________________________________
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CITY:__________________________________
STATE:_________ ZIP:___________ |
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HOME
PHONE :_____________________ WORK PHONE:_____________________ |
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CELL
PHONE :__________________________ E-MAIL:_________________________ |
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Return
your order form with check to:
Playground-Raising
Project
c/o West Mt. Airy Neighbors
6819 Germantown Avenue
Philadelphia, PA 19119-2113
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Please
make checks
payable to:
Playground-Raising
Project/WMAN
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Thank
you for your tax-deductible donation! |
