Form : Great Lakes Aquarium

Lifetime Celebration Fish Order Form

Please fill out this form ONLY if you plan to pay via credit card. If you'd prefer to pay via check, please return to the previous page and click the button labelled "submit payment via check."

Name of Primary Contact*
First Last
Phone*
Email*
Membership ID Number (if applicable)
Your membership ID number is listed on your Aquarium membership card. Please note that donations do not qualify for member discounts.
Lifetime Celebration Fish Quantity
Each Lifetime Celebration Fish costs $100. This price includes three colored, tessellating pieces, engraving and hanging on the wall leading up to Great Lakes Aquarium. There are no additional taxes or fees associated with your purchase. Your purchase is considered a donation to Great Lakes Aquarium.
Price: $100.00
I would like to make an additional donation to Great Lakes Aquarium in the following amount:
Great Lakes Aquarium is a 501(c)3 non-profit organization. We appreciate your support!
Message to be engraved on Lifetime Celebration Fish*
Please provide your inscription below (50 character limit per fish). Inscriptions must be family-friendly and are subject to approval by Great Lakes Aquarium staff.
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Total Number of Tickets
Total
$0.00

Credit Card

Cardholder Name

Card Details

Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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