Father Ted Poteres Retirement Program Book Form
"I have fought the good fight, I have finished the race, I have kept the faith" (2 Tim 4:7)
Name
*
First Name
Last Name
Company Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Upload a JPEG or PDF of your congratulatory or personal message, and/or photos with Fr. Ted as you would like it to appear in the memory book.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Enter your congratulatory message here or how you would like your name(s) listed (optional)
My Products
prev
next
( X )
Full Page Ad
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Half Page Ad
$
60.00
Quantity
1
2
3
4
5
6
7
8
9
10
Patron Listing (Name(s) Only)
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Submit
Should be Empty: