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Use the print
function of your browser to print the order form.
Wildside Walk Brick Order Form
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Enclosed is my check for $50 for one brick
including two lines of type and spaces
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Enclosed is my check for $100 for one brick
including one line of type and spaces plus a nature print
Choose one piece of artwork for each $100.00
brick
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- Bobcat |
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- Raccoon |
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- Butterfly |
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- Great Horned Owl |
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- Coyote Track |
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- Trumpet Vine |
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- Great Blue Heron |
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- Deer Track |
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- Hummingbird |
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- Bobcat Track |
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- Bat |
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- Turtle |
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- Rabbit |
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- Cardinal |
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- Frog |
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- Squirrel |
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- Opossum Track |
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- Fern |
Purchased by:
__________________________________
Address:
__________________________________
City State Zip:
__________________________________
Home Phone:
__________________________________
Work Phone:
__________________________________
Send this message with certificate
In honor of:
_____________________________________
In Memory of:
____________________________________
Special Occasion:
_________________________________
Mail Certificate to:
________________________________________________
________________________________________________
________________________________________________
Clearly print below: Lettering on
bricks is limited to 15 characters per line (including numbers,
spaces and punctuation). Leave Line Two blank if you
choose artwork on your brick.
Line One
Line Two
Make
check payable to
Friends of Lakeside Nature Center
Mail to
Brick Chairman
Lakeside Nature Center
4701 E Gregory Blvd
Kansas City, MO
64132
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