Jesuit Garden Bricks & Plaques Availment Donor InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest 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. Please 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.*YesNoPayment InformationPayment Method:*Credit CardeCheckCredit Card* American ExpressDiscoverMasterCardVisaJCBMaestro Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name eCheck* Name on Account Bank Name Routing Number Account Number CheckingSavingsAccount Type 10kTotal $0.00 CAPTCHA NameThis field is for validation purposes and should be left unchanged.
