FREMONT OAK GARDENS

The first affordable senior housing development with amenities for the Deaf in Northern California

 

 

 

 

Design by Van Meter

Williams Pollack Architects

 

PAVER/TILE FUNDRAISING CAMPAIGN

A Collaboration of the Deaf Senior Retirement Corporation and

the California School for the Deaf in Fremont

 

PLEASE FILL OUT THE FOLLOWING FORM COMPLETELY AND SIGN BELOW:

(Limited Supply: Tiles and Pavers will be sold on a first come, first serve basis)

	CREDIT CARDS WILL NOT BE ACCEPTED   ORDER TOTAL $_________   PLEASE MAKE CHECK OUT TO:  Deaf Senior Retirement Corporation   Please mail your order form and check to:   Deaf Senior Retirement Corp Fundraiser Attn: Bernice Singleton 38181 Hastings Court Fremont, CA  94536   All donations of a tile and paver are tax-deductible.

 

NAME:  ____________________________________________

ADDRESS:              ___________________________________________________

                                Street                                                                     City                         Zip

PHONE, EMAIL, OR TTY______________________________

                                                For Order Verification

 

_____  6”x 6” TILE ($130.00) (Photo on back)

 

FIRST LINE (INCLUDE SPACES)

SECOND LINE (INCLUDE SPACES)

THIRD LINE (INCLUDE SPACES)

FOURTH LINE (INCLUDE SPACES)

 

____    8”x 8” PAVER ($150.00) (Photo on back)

 

FIRST LINE (INCLUDE SPACES)

SECOND LINE (INCLUDE SPACES)

THIRD LINE (INCLUDE SPACES)

FOURTH LINE (INCLUDE SPACES)

FIFTH LINE (INCLUDE SPACES)

SIXTH LINE (INCLUDE SPACES)

 

Customer is to SIGN BELOW ACKNOWLEDGING THAT THE ABOVE ORDER IS CORRECT:

 

 

__________________________________________            ______________

Signature                                                                     Date

*All Engravings will be subject to the approval of the Deaf Senior Retirement Corporation

 

 

 

Thank you for your Support!  If You Have Any Questions, Please Contact Gene Harris at gharris@csdf-cde.ca.gov or Bernice Singleton TTY: (510) 792-8221

Please copy the above form, fill out and mail to:
Satellite Housing, Inc.
DSRC Tile Fundraiser
2526 Martin Luther King Jr. Way
Berkeley CA 954704-2607