Buy a Brick Form

Buy A Brick

Leave Your Legacy with a Personalized Brick. Support ROAR Florida’s mission by leaving a lasting mark on our pathways! We’re raising funds to sustain our ongoing operations and resident programs and enriching the lives of our residents in the place they call home. By purchasing a personalized brick, you’ll contribute to a great cause and become part of ROAR Florida’s legacy: 4x8 Brick: $100 8x8 Brick: $250. Your custom brick will be placed along our pathways, showcasing your support for years to come. Don’t miss this opportunity to make a meaningful impact! Order Your Brick Today!
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please send an acknowledgement of donation to: (Please provide their name, address and phone number in the next field)
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Prefer to Pay by Check?

If you would prefer to pay by check, download and print the Buy a Brick Mail-In Form. Complete the form and mail it with your check payable to ROAR Florida.
Download & Print Mail-In Form

This printable form should collect purchaser name, email, phone number, mailing address, brick choice, engraving details, acknowledgment, and total amount enclosed.

Make check payable to: ROAR Florida

Mail completed form and check to:
ROAR Florida
500 Inspiration Drive
Lakeland, FL 33805
Please engrave our brick as follows:

Any symbol is considered one space (period, comma, dash) All text is centered unless other wise noted
$100 - 4x8 Brick:
Line one: blanks Line two: blank
Line Three: blanks Line Four: blank
Click here to explore available symbols:

Click Here

Instructions:
Browse the available symbols and choose one you’d like to include.
Then write the following:
Symbol: [insert the name of the symbol here]
$250 - 8x8 Brick:
Line One: blanks Line Two: blank
Line Three: blanks Line Four: blank
Line Five: blanks Line Six: blank
Line Seven: blanks Line Eight: blank
Click here to explore available symbols:

Click Here

Instructions:
Browse the available symbols and choose one you’d like to include.
Then write the following:
Symbol: [insert the name of the symbol here]
Acknowledgment
Choose your size:
prevnext( X )
4x8 Brick$100.00

Help Cover Card-Processing Fee

8x8 Brick$250.00

Help ROAR FLORIDA Cover the Card-Processing Fee

Total $0.00
Should be Empty:

Buy A Brick

Prefer to Pay by Check?

Please engrave our brick as follows:

Choose your size: