HomeMy WebLinkAbout8/6/2011 - Agenda Packet (25)I
i
993,x, a
Gifts for Tomorrow Order Request Form
Item # Description
/QC� f�F( L�Pt'ticl')
t�aorua_ ParK
Contact Information Ltde F
't' }}deb
G'a i I Pi aj-v rt MC &.btzan
Nam D $ 01 monoc. lilac e
Mailing Address
� Dori Beach, cA gib6a
c?` q 355 -3375
Phone
Sign ^t'
UndSe� Ades
DEDICATION PLAOUE INFO
Donors my eka to provide a deAtztory plaque if the
value of the donation Is greater than $1,000.
Contact city staff for more Information.
es, l am Interested In dedicatory plaque for my
nation.
Pt'?;4 donated for, "
iL
First Name L= Nam