Skip to content
580.354.7015
|
info@advancesoccercomplex.com
About the Complex
Tournaments and Events
Contact
Gift a Brick Donation Form
Kat Allen
2021-11-16T16:39:01-06:00
Gift a Brick!
From November 20th - December 20th, for every brick donated, we will gift a pair of gloves to a child in need!
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Dropdown Items
*
Small Brick - $100.00
Medium Brick - $500.00
Large Brick - $1,000.00
If you would like to purchase multiple bricks, please submit more than one form.
Total
$0.00
Stripe Credit Card
*
Card
Name on Card
Brick Inscription
*
What would you like the brick to say?
Is this a gift?
*
Yes
No
Would you like us to send a note to the gift recipient?
Yes
No
** If you answer "Yes," please fill out the form that pops up for whom you'd like to receive the note notifying them of your gift!
Name of Gift Recipient
First
Last
Address of Gift Recipient
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Would you like to say anything specific in your note?
Submit
Page load link
Go to Top