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CONTACT INFORMATION spacer
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info@colombianamericancoalition.org
Colombian American Coalition of Florida
16275 SW 88 Street # 163
Miami, Fl. 33196
 
 
 
 
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“La Plaza Colombia Brick Campaign"

Yes, I will support the “Plaza Colombia” project!
Located at Westwind Lakes Park
6805 SW 152 Ave., Miami, Florida
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I have enclosed my donation of $40.00 to go towards the “Plaza Colombia Brick Campaign”. I understand that a brick 4 X 8 X 2 1/4 will be placed and dedicated with the information below on the walkway leading to the “Plaza Colombia” or on the Plaza itself.
   
Name:
A value is required.
Last:
A value is requi A value is required.
Phone:
value is require A value is required.Invalid format.
  Ex. 305-555-5555
Email:
A value is required.
Ex. john@hotmail.com
Address:
Unit. / Apto.:
City:
A value is required.
State:
Please select an item.
Zip Code:
Invalid format.
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Maximum - 3 lines – 18 Characters per line
Brick Wording:
  Words Remaining A value is required.
Signature:
A value is required.
How did you learn about this campaign?
Referral:
 
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