GPSPA BathHouse Renovation Donation

Bathhouse Renovation Form

"*" indicates required fields

Name*

First Last

Email*

Phone

Address

Street Address Address Line 2 City State ZIP Code

- Brick INSCRIPTION - Brick Size Depends on DONATION SIZE ($)

* For a donation of $250-$499 - 4” by 8” brick - 21 characters per line / 4 lines

* For $500-$999 - 8” by 8” brick - 21 characters per line / 8 lines

* For $1000 or more - 12” by 12” brick – 25 characters per line / 9 lines

Inscription

Donation Amount*

Payment Method - Select Check or Credit Card*

Please send checks to: Garrett Park Pool Bathhouse Fund P.O. Box 244 Garrett Park, MD 20896-244

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

CAPTCHA

GPSPA Bathhouse Renovation Donation

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