OSPAC Paver Form

PAVE THE WAY

Purchase an engraved paving stone to permanently commemorate your support of OSPAC

I would like to purchase a Paver (please complete the inscription form below)

Patron Paving Stone 6 X 9
$ 100

Pace Setter Paving Stone 6 X 9 Prime Location $ 150

Prime Path Paver 12 X 12 $ 250

Prestige Path Paver (Business/Corporate) $ 500

Total Enclosed $ _____

I am interested in Corporate Commemorative Plaques and Benches. ________

Please make checks payable to:

OSPAC
5 Yale Terrace
West Orange, NJ 07052

Patron and Pace Setter Paving Stone - 6 X 9 A maximum of three lines
14 characters per line including spaces and punctuation

_____________________________________________

Prime Path Paver and Prestige Path Paver - 12 X 12 A maximum of six lines, 16 characters per line including spaces and punctuation.

_____________________________________________

Please provide us with contact information so we can confirm your inscription. All contact information will be kept confidential

Name: _____________________________________________

Phone: _____________________________________________

Email: _____________________________________________

Patron Paving Stone 6 X 9	$ 100
Pace Setter Paving Stone 6 X 9 Prime Location	$ 150
Prime Path Paver 12 X 12	$ 250
Prestige Path Paver (Business/Corporate)	$ 500

Total Enclosed	$ _____