Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bricks are 4"x8". Each brick may contain up to 3 lines of copy, 17 characters per line. Any symbol is considered one space (period, comma, dash.) All text is centered.
*
Rows
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Row 1
Row 2
Row 3
Form of Payment
Please Select
Paypal
Check
Please make checks payable to the First Presbyterian Church of Michigan City 121 W. 9th St., Michigan City IN 46360. Memo: Brick
If Paying via PayPal, once you submit the page will redirect you to the Giving Fund.
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