
Located at the corner of
The
The committee welcomes gifts of any size. In addition,
anyone donating $100.00 or more will have their loved one's name(s) inscribed
on a plaque that will be installed inside the Gazebo structure. Please contact
our Village Treasurer
******************************************************************************************************************
Name of Donor:
__________________________________________________________________________________________
Address:
_________________________________________________________________________________________________
Phone Number
____________________________________________________________________________________________
Name of Veteran: _________________________________________________________________________________________
Military Branch:
_______________________________________ War or Conflict:
__________________________________
Please check one of the boxes below
q A – Contribution of $2,000.00 (Sponsor)
q B – Contribution of $1,000.00
q C – Contribution of $500.00
q D -
Contribution of $100.00
q E
- Contribution of $______________
Donations of $100.00 or more entitles the
donor to have the veteran’s name inscribed on a plaque that will be installed
inside the Gazebo. Please be brief. Heading on the Plaque
“WITH LOVE and HONOR WE REMEMBER…”
Name as it should appear on plaque:
______________________________________________________________________
Examples: The Smith Family or Bill Smith
Bill Smith
Please return this form along with your
donation to the following address: