Memorial Brick ProgramThe Memorial Brick Program was designed to provide working capital for Kamp Kiwanis. Each brick is custom engraved with the name of the Person, Club, Division, or in Memory of the Very Special Person in your club. These bricks will enclose Governor's Hall at Kamp Kiwanis.
Date _______________________ Name (of ordering individual) ______________________________________ Address ____________________________________________________________ Telephone _______________________ Select the size and check the box of the brick size you prefer. Write the inscription you would like placed on the brick (using the guidelines shown). Make you check payable to: The NY District Foundation Brick Program and mail with your order form to: New York District Kiwanis, 1522 Genesee St., Utica, NY 13502. ______ 4" x 8"; 2 lines, 13 spaces per line. Cost: $100 ______ 16" x 16"; 9 lines, 30 spaces per line. Cost: $640 ______ 12" x 12"; 6 lines, 20 spaces per line. Cost: $385 ______ 24" x 24"; 12 lines, 40 spaces per line. Cost: $1,350 Inscription to be placed on brick:
Please place order (Signature) _________________________________ |