Rochester Hope for Pets Brick Order Form
Thank you for considering purchasing a Rochester Hope for Pets brick! If you have any questions, please don't hesitate to contact us at info@rochesterhopeforpets.org or 585-532-7406.

If ordering more than one brick please fill out a separate form for each.
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Your name *
E-mail *
Phone number *
Address *
If you like us to notify someone else once the brick is installed, please enter their name and address here.
Which item would you like to purchase? *
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