Bloom-struck Registration

I Wish to Dedicate a Piece of The Garden at Newfields *

"In Honor" or "In Memory"

In Honor In Memory

Of (To Be Printed on Plaque) *

From (To Be Printed on Plaque) *

Option Message to be Printed on Plaque (50 Characters Max.) *

Please send an acknowledgement letter to (Donor Full Name): *

Mailing Address *

City *

State *

Zip Code *

Phone Number *

Is the Donor a Newfields Member? *

Yes No

Do you wish to notify anyone of this gift? If so, please provide their contact information below.

Recipient Full Name

Recipient Mailing Address

City

State

Zip Code

Recipient Phone Number

Is the Recipient a Newfields Member?

Yes No

Anything else the Newfields team should know?

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