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Brick Order Form

Please use fill out a separate form for each brick that you order. All donations are 100% tax deductible.

Way of the Cross Garden Brick Order Form

Brick Options *4x8 Brick: $1258x8 Brick: $250

Text on Brick
Maximum of 20 characters per line, including spaces and characters. 4x8 Brick contains up to 3 lines of text. 8x8 Brick contains up to 6 lines of text.

Line 1

Line 2

Line 3

Line 4

Line 5

Line 6

Contact Information

First Name *
Last Name *

Street *

Apt, floor, suite, etc.

City *
State *
Zip *

Phone *
E-mail *

Would you like to receive a certificate sent to you to commemorate your purchase? *YesNo

A payment link will be provided after this form is submitted.

Current month ye@r (4 digits) day *