Rocking Chair Donation | Glen Lake Camp & Retreat Center

Rocking Chair Donation Form

Please fill out the form below and we will contact you to receive your payment of $350.00. We can't order your rocking chair until the payment is received.

Donor Name *

Title

First

Last

Suffix

Donor Address *

Street Address
Address Line 2
City	State / Province / Region
Zip / Postal Code	Country

Donor Phone *

(###)

###

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Plaque Wording

Payment Options - $350 per chair Credit by phone (MasterCard, Visa or Discover)
Check by mail

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Optional Notification Name

Title

First

Last

Suffix

Optional Notification Address

Street Address
Address Line 2
City	State / Province / Region
Zip / Postal Code	Country

Email *

Giving Opportunities
Ways of Giving
Brick Donation
Rocking Chair Donation
Online Giving