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.orgwebsite:
www.cdlh.orgCírculo 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