Donation Form for 12" x 12" Glass
Blocks
If a group, individual, or business makes a donation
of $1000 or more and would like to have their name(s) engraved into a block,
the form below may be used. These blocks will become part of a large, glass
cross which will stand in front of the monument.
| Name of Donor | ||||
| Street or Box | ||||
| City, State, Zip | ||||
| Phone Numbers | - - | |||
| - - | ||||
| Amount of Donation | ||||
Inscription:**
Print and Mail to: Raphael's Refuge, P.O. Box 341,
Flatonia TX 78941-0341
If you have questions, contact us at
raphaelsrefuge@att.net .
**Examples:
|
First Baptist Church |
The Smith Family
John and Mary David, Lisa, and Liz City, TX January 28 2008 |
The J. Smith Company South, TX
2008 |
Raphael's Refuge is a non-profit 501(c)(3) organization. Donations are tax-deductible to the extent allowed by law .