Our Lady of Guadalupe Parish, Fremont, CA
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Our Lady of Guadalupe
8x8 Brick Order Form
Please complete the required fields indicated by the *
, then enter your inscription and click on the submit button at the bottom of the form. PLEASE ENTER THE TEXT EXACTLY AS YOU WANT IT TO APPEAR ON THE BRICK. This form is for all language.
*
Indicates required field
Order Date
*
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Cell Phone
*
Email
*
Payment
*
check
cash
Credit Card
Payment Plan with $50 deposit
Payment Instructions:
1. Check - please mail to the Parish Office, 41933 Blacow Road, Fremont CA 94538. Please indicate on the memo line "Brick Fundraising".
2. Cash - please drop it off at the Parish Office (parish hours Monday - Friday 9 am to Noon and 1 pm to 3 pm.
3. Credit Card - please call Parish office 510-657-4043 to pay it by phone.
4. Payment Plan, please call Parish office 510-249-1770 to arrange the payment plan.
Wall Brick 8x8
(max. 6 lines)
$250 each
Quantity
*
Total Amount $
*
Centered the script?
*
select one
Yes
No
Select Yes or No if you want your scrip to be centered.
Line 1 Max. 21 letters including all spaces, symbol and punctuation
*
Line 2 Max. 21 letters including all spaces, symbol and punctuation
*
Line 3 Max. 21 letters including all spaces, symbol and punctuation
*
Line 4 Max. 21 letters including all spaces, symbol and punctuation
*
Line 5 Max. 21 letters including all spaces, symbol and punctuation
*
Line 6 Max. 21 letters including all spaces, symbol and punctuation
*
All submissions are final and changes will NOT be made, so please verify your inscription prior to submitting!
THANK YOU FOR YOUR SUPPORT!
Submit
