Armourdale Historic Courtyard
Business Brick Order Form

Name:____________________________________
Address:__________________________________
City:_____________________________________
State:________________________Zip:__________
Phone:(           )_____________________________
Ordering Instructions:
Each brick can be imprinted with 3 lines of up to 15 characters each (including spaces).  PLEASE PRINT IN CAPITAL LETTERS the name or the message you would like on your special Armourdale brick.  Armourdale Renewal reserves the right to choose type size and arrange words to maintain the balance and improve legibility.  Please write a check to Armourdale Renewal Association, or ARA, and write (brick order) on the memo line.  Mail to ARA, PO Box 5272, KCK 66119.  Please sign the statement of verification in the left hand corner of this sheet.  See the attached letter for pricing information. All specialty logos will be priced separately by preferred order. Call Patty Dysart for more information at (913)371-5696, or Fax to (913) 621-2660.

Here's how you can be a part of this commemoration:
21st Century to the Future: $5000.00
Diamond Jubilee Donor: $2000.00
Golden Jubilee Donor: $1000.00
Silver Jubilee Donor: $500.00
A True Armourdalian: $250.00

Golden Jubilee and up ($1000-$5000) will receive 2-4 bricks with imprint and choice of location. Silver and True Armourdalian will receive 2 bricks with imprint.  Logos will be priced separately per order.

MESSAGE SELECTION
Can be NO more than 15 characters
Brick One
Line One
                           
Line Two
                           
Line Three
                           
Brick Two
Line One
                           
Line Two
                           
Line Three
                           
Brick Three
Line One
                           
Line Two
                           
Line Three
                           
Brick Four
Line One
                           
Line Two
                           
Line Three