Jesuit Garden Bricks & Plaques Availment Donor InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Bricks and Plaques SizesPlaques are custom designed. We will contact you regarding the engraving. HiddenPlease select:* 12x12 Wall of Remembrance Plaque 6x6 Wall of Remembrance Plaque 4x6 Wall of Remembrance Plaque 4x8 Brick (includes up to 3 lines of content with up to 15 characters/spaces per line) Please indicate engraving for bricks below:Engraving Text for Bricks (first line)* 0 to 15 max charactersEngraving Text for Bricks (second line)* 0 to 15 max charactersEngraving Text for Bricks (third line)* 0 to 15 max charactersThose who have remembered Manresa in their will or trust are invited to join the St. Ignatius Legacy Society. Among other benefits, members will be listed on a special plaque in the Jesuit Garden. Please indicate if you are, or wish to become, a member.* Yes No Payment InformationPayment Method:* Credit Card eCheck Credit Card* American ExpressDiscoverMasterCardVisaJCBMaestroSupported Credit Cards: American Express, Discover, MasterCard, Visa, JCB, Maestro Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name eCheck* Name on Account Bank Name Routing Number Account Number CheckingSavingsAccount Type 10kTotal $0.00 CAPTCHA PhoneThis field is for validation purposes and should be left unchanged.
