Brick/Paver Form

Brick/Paver Information

Amount

• $250 CELEBRATION TRIBUTE BREEZEWAY BRICK
Up to 5 lines with a maximum of 14 characters per line*

• $125 ALEC BUILDING BRICK
Up to 3 lines, with a maximum of 14 characters per line*

Paver Line 1

Paver Line 2

Paver Line 3

Paver Line 4

Paver Line 5

I would like to dedicate this donation

Contact Information

First Name

Last Name

Address

City

State/Province

Zip/Postal Code

Cell Phone

Help Us Cover Costs

Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.

Yes! I want $250.00 to go to Unity School and I will donate $257.50.No. I will donate $250.00 and Unity School will cover the processing costs.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.