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16

17

B

uy

A B

rick

P

rogram

Círculo de la Hispanidad’s commemorative brick program is a wonderful way to recognize a loved one

or to show your support to the organization. Funds raised through this project help us reach our dream

to complete and maintain our “green” Center. To make your pledge please fax a copy of this form or

forward via e-mail or US Postal Service to our office at the addresses listed on this form. A separate form

must be used for each brick you wish to inscribe. Please keep a copy for your personal records.

• 6“ X 6“ BRICK

Individual Rate

Friend Rate

Supporter Rate

Individual Rate

Friend Rate

Supporter Rate

$100

$175

$250

$150

$300

$500

• 6“ X 9” BRICK

This brick includes 9 characters per line including spaces and has four rows total. Use the format

sample below to fit your message using 1 box per letter or space. Use this format as a sample to

order additional inscriptions.

C

ontribution

L

evels

R

equest

A P

ledge

F

orm

This brick includes 14 characters per line including spaces and has four rows total. Use the format

sample below to fit your message using 1 box per letter or space. Use this format as a sample to

order additional inscriptions.

Contact Círculo de la Hispanidad for an order form and additional instructions.

Círculo reserves the right to approve all brick pledges, contributions are tax deductible.

Contact Information:

Gloria Robles Tel: (516) 431-1135 Fax: (516) 431-2307

e-mail:

grobles@cdlh.org

website:

www.cdlh.org

Círculo de la Hispanidad

Center

605 Peninsula Blvd.

Hempstead, New York

11550

Círculo’s After-School Program Long Beach

CÍrculo After School Programs

East Scho l of L ng Beach