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2. First Name*
3. Last Name*
5. Email Address
6. Phone Number
8. Mailing Address
9. State
10. Zip
12. Park Project Funds*
    -- Select One --Azalea Park Athletic Field Reconfiguration/All Weather Turf ProjectAzalea Park Kidtown Playground Repairs/UpgradesAzalea Park Native Azaleas Mainentance FundCapella by the Sea Maintenance FundBud Cross Day Use Picnic AreaBud Cross Ball Field ScoreboardsBud Cross Tennis Court ResurfacingBud Cross Skate Park FencingBud Cross Playground EquipmentLower Stout Park FundStout Park Unleashed Pet AreaStout Park Day Use Picnic AreaStout Park RestroomsChetco Point RestroomsChetco Point Parking Lot PavingChetco Point Multi Use Field Access PathEasy Manor Park Playground Maintenance FundOasis Park FundTanbark Overlook/Beach Access TrailHarris Beach Multi Use Path - Southern LegChetco Bridge Overlook Picnic Area
14. I would like my donation to be anonymous

    1. Yes
15. Type your name as you wish to appear on annual Donation Report
17. Payment Information
    Select from one of the following
18. Pay with Credit Card:
    Call 541-469-1125 to pay with a credit card
20. - Or -
22. Print out form and mail with check to:
    City of Brookings 898 Elk Drive Brookings, OR 97415
23. Make checks payable to:
    City of Brookings Parks Donation
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit Submit and Print

* indicates a required field