NEWS

Memorials and Certifications

Order your Card or Certificate

Step 1: Select the occasion

Step 2: Select the format

Card
minimum donation of $10

Parchment certificate
minimum donation of $50

Parchment certificate with linen cover
minimum donation of $100

Parchment certificate with leatherette cover
minimum donation $500

Step 3: Enter the amount you would like to contribute for this card/certificate
*Amount:	$.00
*Honoree Name or In Memory Of Name:
Your special message: (255 characters maximum, including spaces)	characters left: 255

Step 4: Enter the name and address for the recipient of this card/certificate:
*Recipient's Name:
*Recipient's Address 1:
Recipient's Address 2:
*Recipient's City:
*Recipient's State:
*Recipient's Zip:

Step 5: How would you like your name to appear on the card/certificate? (e.g. Jeffrey Smith or The Smith Family or Anonymous)
Your Name: (as you'd like it to appear on the card/certificate)*

Step 6: Enter your personal information
*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State:
*Zip:
Home Phone: (123-456-7890)*
Work Phone: (123-456-7890)
Cell Phone: (123-456-7890)
*E-mail:

3834 N. Cicero Ave., Chicago, Illinois, 60641 Tel: 773-282-8206
6276 W. Archer Ave., Chicago, Illinois, 60638 (South Side) Tel: 773-767-7773
Office hours: Mon.-Th. 9 am-5pm Fri. 9am-3pm
Copyright © 2012 Polish American Association