BUY A BRICK ORDER FORM
Raymond Historical Society Commemorative Walkway
Name ____________________________________________________________
Address___________________________________________________________
City________________________ State _______________________Zip_______
Telephone_________________________________________________________
Number of Bricks____________ x $50 Donation = Total $_______________
Instructions:
 ·Up to 3 lines per brick
·Up to 14 Characters per line - including spaces and punctuation
·Please print clearly – in all capital letters
·Make your check payable to: Raymond Historical Society
·Send order form and payment to:
   Raymond Historical Society, P.O.Box 94, Raymond NH 03077
·Keep a copy of this completed form for your records
Please engrave my brick(s) with the following inscription (s):

Brick #1 (Engraver will center all type) 

  

 Example #1
                           
                           
                           
 
I N   M E M O R Y          
J O H N   J   S M I T H    
                           

 Brick #2  (Engraver will center all type)

  

Example #2 
                           
                           
                           
 
H A P P Y   B I R T H D A Y
M A R G A R E T   J O N E S
A U G U S T   5 ,   2 0 0 3

 Brick #3  (Engraver will center all type)

  

 Example #3
                           
                           
                           
 
M I L D R E D   E   H A L L
B O S T O N   P O S T      
C A N E   1 8 8 9 - 2 0 0 3

Questions? Call the Marge Disjardins 603-895-2770