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

 
Donation Date: 05/17/24
 
* 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.