Plaque Form

 

Home
Up

 

I wish to memorialize a pew.

Please list next to one of the following headings below the name(s) you would like engraved on the 1" x 3"plaque:

In memory of __________________________
OR
Donated by ____________________________
OR
Gift of ________________________________
OR
Dedicated to ___________________________

 

I wish to memorialize a Stained-Glass Window.

Please list next to one of the following headings below the name(s) you would like engraved on the 2" x 10" plaque:

In memory of __________________________
OR
Donated by ____________________________
OR
Gift of ________________________________
OR
Dedicated to ___________________________

 

I wish to memorialize a Station of the Cross.

Please list next to one of the following headings below the name(s) you would like engraved on the 1" x 3" plaque:

In memory of __________________________
OR
Donated by ____________________________
OR
Gift of ________________________________
OR
Dedicated to ___________________________

 

Payment Information

I am paying in full. My check in the amount of $___________ is enclosed with this form.

I will be paying in two installments. I am enclosing my first payment with this form in the amount of $_________.

My second payment in the same amount is due on or before ______________.

I will be paying in three installments. I am enclosing my first installment with this form in the amount of $ ________.

The 2nd payment is due on or before _____________ and the 3rd on _______________.

Payment is fully tax-deductible. Full payment must be made within 180 days.

Name: ________________________________

Address: ______________________________

______________________________________

Phone: ________________________________

Email: _________________________________

 

Checks may be made out to Church of St. Elizabeth of Hungary and returned to 211 East 83 Street NY, NY 10028