Bricks for Badges

Online Brick Order Form

 

Guidelines for Text

When personalizing your brick, please refer to these guidelines:

     � There are 3 lines per brick, maximum 20 characters per line.

     � Each letter, space, punctuation mark or number counts as a character.

     � Letters may be in upper and lower case.

     � Acceptable punctuation marks are:   ~  !  @  #  $  %  ^  &  *  (  )  +  =  :  ;  "  '  <  >  ,  .  ?  /

     � All text will be automatically centered on each line - you need not center it below.

     � No inappropriate language will be accepted.

 

Donation Information

One 4" x 8" brick and one mini-brick  (1�" x 3") ....... $150.00     

Each additional mini-brick ........................................... $15.00              

 

Contact Info

Name:

Street Address:

City:    State:   Zip:

Day Phone:

Night Phone:

E-Mail:

Date:

 

Text

Please personalize my brick as follows (maximum 20 characters/spaces per line):

Line 1

Line 2

Line 3

 

Total Payment 

Calculate your total payment, type it into the box above, then click on Submit below. You will receive a confirmation notice that your order has been submitted, and you may then make a secure payment online via Paypal. Thank you very much for your donation.

 

 

 

 

 

 

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