Veterans Memorial Walk Of Fame Bricks Order Form Purchaser Name: _____________________________________________________________ Purchaser Address: ___________________________________________________________ Purchaser Telephone: _________________________
_____________________________
Purchaser Email Address: _____________________________________________________ Number Of Bricks: _____ @ $ 125 ( SINGLE 4 X 8 )
_____ @ $ 250 ( DOUBLE 8 X 8 )
Total Enclosed: $ _________________ SINGLE BRICK INSCRIPTION(S):
#1 #2 #3
#4 -------------------------------------------------------------------------------------------------------------------------------------DOUBLE BRICK INSCRIPTION(S): #1 #2 #3 #4 #5 #6 #7 #8 PLEASE NOTE - Inscriptions are limited to the following: Single Brick: 4 lines of text, Double Brick: 8 lines of text. Each line is limited to 15 characters including all spaces and punctuation. Make Check Payable To: CITY OF ALABASTER (Include Drivers License # and Phone # on check) Mail Form and Payment To:
Veterans Memorial Fundraiser Alabaster Parks And Recreation 100 Depot Street Alabaster, AL 35007
For more information, please call: (205) 664-6840 or email: rnance@cityofalabaster.com