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Brass Block Order Form

Use the form below to order your personalized brass block. Please note that brass blocks will not be displayed at the adoption center until Phase Two is completed.

 

Cost of brass blocks are:

$ 50.00 - Two Line Engraving

$ 65.00 - Three Line Engraving

$ 80.00 - Four Line Engraving

 

Your Contact Information

First Name
Last Name
Organization
Street Address
Address (cont.)
City
State
Zip Code
Work Phone
Home Phone
E-mail

 

Engraving

Maximum 15 characters per line (including spaces)

Line One  
   
Line Two  
   
Line Three  
   
Line Four  


Gift

Is this block being purchased as a gift for someone?

Yes No

If yes, please provide the following information for the recipient:

(this will be the name and address we send the notification to)

First Name
Last Name
Street Address
Address (cont.)
City
State
Zip Code
Home Phone
E-mail

 

After hitting the Submit Form button below you will be directed to a web page where you can complete your purchase through PayPal.


If you prefer to place your order by US Mail, please click
here to print our order form.

 


South Lake Animal League's A Haven Before A Home Adoption Center
Copyright © 2010. All rights reserved.
 
 
   

 
 


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