Capital Campaign Donation Form

Thank you for joining us as we build the future home for our high school students.

Gift Information

Quantity
Price
Total
Brick Donation
X
$
5,000.00=
$
0

Grape Cluster
X
$
3,500.00=
$
0

Vine Gold Leaf
X
$
2,000.00=
$
0

Vine Silver Leaf
X
$
1,000.00=
$
0

Vine Bronze Leaf
X
$
500.00=
$
0

Final Total:
$
0

Tribute Information

Tribute Name

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code