Baptismal Pavers Order Form 2021
Please complete this form to purchase Baptismal Pavers. Each paver is $80. Baptismal Pavers include the first and last name (including Jr, Sr, III, etc.) and the baptism date of the person baptized and if it was at St. Peter's. Please include the baptismal date if known - if the date is not know, the office can assist in finding the date. Please make checks payable to: St. Peter's Lutheran Church MEMO: PAVERS. Mail or drop checks at the office: 211 S. Main Street, North Wales, PA 19454. Orders must be received by May 31, 2021.
Name of Purchaser
Purchaser Preferred Contact Information (phone and/or email)
Paver #1: Baptized Name (First & Last & Suffix) $80
Paver #1: Baptism Date (if known - if unknown the church office can supply).
Paver #1: Baptized at St. Peter's?
Clear selection
Paver #2: Baptized Name (First & Last & Suffix) $160
Paver #2: Baptism Date (if known - if unknown the church office can supply).
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YYYY
Paver #2: Baptized at St. Peter's?
Clear selection
Paver #3: Baptized Name (First & Last & Suffix) $240
Paver #3: Baptism Date (if known - if unknown the church office can supply).
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/
DD
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YYYY
Paver #3: Baptized at St. Peter's?
Clear selection
Total Number of Pavers Purchased:
Total Payment ($80 per paver):
Clear selection
FOR OFFICE ONLY: payment received:
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YYYY
Submit
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