Glen Carbon Centennial Library

Brick Paver Form

Donor's Name:

Address:

Phone Number

Amount of Pledge:

4x8 Brick  Paver - $100.00 (13 characters and spaces per line - 3 lines) 

8x8 Brick  Paver - $250.00 (13 characters and spaces per line - 6 lines)   

12x12 Granite Paver - $1000.00 (18 Characters and spaces per line - 8 lines)

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Make checks payable to:

ILSDO (Illinois Library Systems Donor Organization)