Wall of Victory Pledge Form

Once you have sent in your donation you will then need to print and fill out a pledge form.

Please fill out the form completely with what you would like to appear on your leaf or your rock.

(Please use Adobe Reader to view and print the form.)

Return completed form by mail to:

Mrs. Louvenia Kirby, Secretary

P.O. Box 822

Pittsboro, NC 27312

Phone (919) 542-2884

Fax (919) 542-2642

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