Brick/Paver Form

Thank you so much for your interest in a commemorative brick, tile, or bench. Should you have any questions, please contact Elizabeth Wojtysiak, Development Manager, at (517) 626-6060 ext. 125 or [email protected].

Commemorative Information

Amount

Please enter your text below. (Max 14 characters per line)

Line 1

Line 2

Line 3

I would like to dedicate this purchase to someone.

Contact Information

First Name

Last Name

Company Name

Address

Address 2

City

State/Province

Zip/Postal Code

Home Phone

Cell Phone

Help Us Cover Costs

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

Yes! I want $250.00 to go to Capital Area Humane Society. and I will donate $257.50.No. I will donate $250.00 and Capital Area Humane Society. 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 keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.

Capital Area Humane Society

7095 West Grand River Avenue, Lansing, MI 48906

(517) 626-6060

[email protected]