Women in Support of the Million Man March





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BUY-A-BRICK ORDER FORM

Honor yourself or your loved ones. Engrave the name/names or passage of your choice on the “Sacred Wall”, an ancestral tribute and memorial to the fallen Africans who perished in the Maafa (the African Slave Trade). This worthwhile, historical project was unveiled in WISOMMM’s Children Garden during the Summer, 2003.

You can purchase one or more bricks with the inscription of your choice. Honor your family, loved ones, heroes, sheroes or affiliations. Each brick will be inscribed with up to three lines of text (14 characters per line-spaces count as a character).

All donations are tax-deductible and will benefit the WISOMMM Holistic Child Care Center. You can visit the Sacred Wall and view the Sacred Mural at the WISOMMM headquarters, 53 Lincoln Park-Newark, New Jersey. For an appointment please call 973-297-1275.

CONTRIBUTION LEVELS:

FRIEND'S PACKAGE	MEMBER'S PACKAGE	HERITAGE PACKAGE
For $100 you are entitled to 1 engraved brick with the name of your choice that will be built into the WISOMMM "Sacred Wall" in the beautiful WISOMMM Children's Garden.	For $150 you are entitled to 1 engraved brick with the name of your choice and a 1 year membership to WISOMMM. Membership includes a membership card, 10% discount on WISOMMM events and products for 1 year.	For $500 you are entitled to 1 engraved brick with the name of your choice, 1 year family or corporate membership to WISOMMM with all membership benefits, and free advertisement on www.wisommm.org.

ORDER FORM:
*Required Fields.

NAME:	*
ADDRESS:
APT/SUITE:
CITY:
STATE:
ZIP:
PHONE:	*
FAX:
EMAIL:	*
INSCRIPTION	Inscription (No more than 3 lines, 15 characters per line) *

CONTRIBUTION LEVEL:	*
PAYMENT METHOD:	*
CREDIT CARD #:	code:
EXPIRATION DATE:

Thank you.