Brick Order Form

  Order Form
   
  Name _________________________________________

  Address ______________________________________

  City _________________________________________

  Zip __________

  Phone ______________
   
  ______ Bricks @ $50 each  __________
   
  Visa, Mastercard, Discover # ______________________________________
  Expiration Date ________________
  Signature _______________________

  Make check payable to SAC, 206 Curwood Castle Drive, Owosso, MI  48867

  Engraved bricks are 4" x 8" and are available for $50 each and can accommodate three lines
 (two lines are recommended), 14 letters/spaces per line. 

 The amount is tax deductible, less cost of the brick. Visa, Mastercard or Discover accepted.
 
  Print exactly as you would like the engraving to appear. 
  Use one letter per box, leaving a box blank for each space between words. 
  
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