Patriot Paver Order Form
One Paver Per Form Please
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
12" x 12" Personalization - 8 Lines 21 Characters per Line: Fill in exactly as it should be inscribed. Every letter, punctuation mark, and space is included in the character count. All text will be centered on brick pavers. $500 Donation
0/168
8" x 8" Personalization - 5 Lines 16 Characters per Line: Fill in exactly as it should be inscribed. Every letter, punctuation mark, and space is included in the character count. All text will be centered on brick pavers. $300 Donation
0/80
Paver Size Options - *One Paver Per Form Please*
*
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( X )
12" x 12" Patriot Paver
Up to 8 lines of text, 21 characters per line
$
500.00
8" x 8" Patriot Paver
Up to 5 lines of text, 16 characters per line
$
300.00
Please ensure you have selected the correct paver size and verify that all personalization details are accurate before completing your purchase.
Thank you for your support!
Complete Purchase
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