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Buy a Brick

To buy a brick please fill out the following form or print
this form and mail it with a check. Our form is designed
for one brick at a time so if you would like to buy more
than one, please fill out this form for each purchase. Once
you submit the information you will be passed to PayPal for
a secured completion of the transaction. (Your information will
not be shared with any other organization.) *Required fields
*First Name: *Last Name:
Address:
City: State: Zip Code:
*Phone: *Email:

4"X 8" Bricks can be inscribed in either 3 lines of 14 characters or 2 line of 20 characters.
Leave spaces between words and do not hyphenate or continue words over two lines.

(3 Rows of 14 Characters)
Line 1:
Line 2:
Line 3:

OR
(2 Rows of 20 Characters)
Line 1:
Line 2:

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