Pinwheel Form

Pinwheel Garden / Personal Pinwheel Garden

Please fill in the form below.
Full Name*

PrefixFirst NameLast Name
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Start Date preference (if any)
00/00/0000
Type of Pinwheel Requested*
Pinwheel Slection
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Pinwheel Garden$50.00

Quantity

Personal Pinwheel$25.00

Quantity
Item subtotal:$0.00

Total $0.00
Payment Method:

-        Make check payable to Exchange Club Family Support Center

-        Credit/Debit Payments:

Can be made in person at the Center - 8320 Iowa Street, Downey, CA 90241 or

Online via our website www.DowneyFamilySupport.com “DONATE” button or

through the Exchange Club Family Support Center Facebook page

For questions, please call the Center at 562-904-9590

THANK YOU FOR BEING A PART OF THIS EFFORT TO SHOW YOU CARE.

YOU MAKE A DIFFERENCE!!
Questions or comments
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