Sumter S.C. SPCA
Pawprint Pathway Brick Secure Payment Form

 
Donation Date: 08/21/17
           
* Credit Card Information:
Card Type:

Name as on Card:
Card Billing Address:
Card Billing Zipcode:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
 
[What is the Card ID?]

Select Brick Size

$100.00      4" x 8" Deep Iron Spot Standard Series
     with up to 3 lines of text.
$175.00      8" x 8" Deep Iron Spot Standard Series
     with up to 6 lines of text.
   
Individual Purchasing Brick
Company Name:
* First Name:
* Last Name:
* Address:
Address Line 2:
* City:
* State:
* Zip:
Country:
* Phone Number:
Email Address:
     
Acknowledgment Information for Family of Pet(s):
* Individual(s)
Name Being Honored
* Family Name:
* Address:
* City:
* State:
* Zip:
Country:
Phone Number:
Brick Text Information
Each line of text is allowed a maximum of 15 characters (spaces, punctuation, etc. count as a character). Any symbol on a standard computer keyboard is acceptable.

Please note the appropriate number of lines of text available for each type of brick. You are allowed a total of 3 lines, 15 characters per line, for a 4x8 brick, and 6 lines, 15 characters per line, for an 8x8 brick.

Please count carefully as only the first 15 characters per line can be used.

Line 1:

Line 2:

Line 3:

**8x8 brick only - Line 4:

**8x8 brick only - Line 5:

**8x8 brick only - Line 6:

   


We thank you for your generous and kind memorial donation to our organization.
We are honored to be the recipient of this donation.

Your donation is tax deductible.

You may also want to consider purchasing a brick for our Pawprint Pathway.
It is an everlasting tribute to the memory of a loved one, friend or a beloved pet.