Paver Form

Donor Information

Name

Street Address

Street Address Line 2

City

Postal / Zip code

Phone

Order Pavers

One Paver ($350)

Two Pavers ($650)

Three Pavers ($950)

Donation to BeneTrou Memorial Garden

Payment Choices

Check

Cash

Online/Paypal

Total Donation

Please complete the text you would like engraved. (Paver 1)

Please complete the text you would like engraved. (Paver 2 if applicable)

Please complete the text you would like engraved. (Paver 3 if applicable)

Thanks for submitting!

Paver Inscription Guidelines:

Each 6"x9" Paver may contain up to 3 rows of copy.

Each box represents a letter number, punctuation or space.

You may use up to 18 boxes per row. (You don’t have to use every box within the row)

All engraving will be centered

One order form per Paver.

All Questions Regarding Pavers or Paver placement, Contact: