"Leaves of Inspiration" Pergola Submission Form

"Leaves of Inspiration" Pergola Submission Form

Leaf Wording / Leaf Honouree Story
Your Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Please note we are only collecting emails and phone numbers strickly for the Pergola Project to contact you if we need to A. clarify any of the information you have provided and B. provided you with any updates or news about the pergola.
Purchase completed?*

Online (CanadaHelps)ChequePending
Please provide the wording you wish to have engraved on the leaf. *
Maximum number of characters (including spaces, brackets, etc.) is 28 [excluding the #]. As per these examples.
Story Submission for your Leaf Honouree (500 word max.) Optional. See Writing Tips.

0/500
Writing Tips for your story...
Your Leaf # preference (although not guaranteed) is:
Once we have received your submission we will get back to you to advise if any revisions may be required. We will keep you informed by email as to the status of the installation of your Leaf.

Thank you for your support of the
"Leaves of Inspiration" Pergola Project.
Should be Empty: