Looking for a great gift idea for a parent or perhaps an aunt,
uncle or other beloved person in your life?
Provide a gift that keeps on giving and one that also gives you the
peace of mind of knowing that someone else is helping you look
out for the folks you care about.

Please be sure to touch base with our Program Director,
Karen Jones ([email protected]) before your purchase to
assure that the Village services are right for your friend or family member.
Your Full Name: _____________________________________________________________________
Street Address: ______________________________________________________________________
City: _________________________________ State: ____ Zip Code: __________________________
Gift Certificate Amount (Please Check One):
$100
# of Certificates You Would Like to Order (Circle One):
Payment Method:
$200
1
2
$300
3
4
$400
5
6
Check (Please make check payable to Mt. Lebanon Village)
PLEASE DETACH THIS FORM AND MAIL WITH PAYMENT TO:
Mt. Lebanon Village
710 Washington Road
Pittsburgh, PA 15228
7
8
9
10
Money Order