EmailMe Form - Rotary Club of Spring Hill Central Brick Fundraise

Choose Your Brick *
4” x 8” bricks can have up to 3 lines of text , 20 characters per line without clip art and 16 characters with clip art
8” x 8” bricks can have up to 5 lines of text , 20 characters per line with or without clip art.
Click to display or hide clip art.
Please add clip art (Add $25)
Please include a Mini Replica Brick for my home or office (Add $25)
Line 1:
Must be between 0 and 20 characters, currently: 0.
Line 1:
Must be between 0 and 16 characters, currently: 0.
Line 2:
Must be between 0 and 20 characters, currently: 0.
Line 2:
Must be between 0 and 16 characters, currently: 0.
Line 3:
Must be between 0 and 20 characters, currently: 0.
Line 3:
Must be between 0 and 16 characters, currently: 0.
Line 4:
Must be between 0 and 20 characters, currently: 0.
Line 5:
Must be between 0 and 20 characters, currently: 0.
Choose Your Clip Art
Upload Your Custom Logo
Maximum File Size 5MB. Black and White 300DPI Preferred.
Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Phone *
### - ### - ####
Email *

Total $100.00

4” x 8” bricks can have up to 3 lines of text , 20 characters per line without clip art and 16 characters with clip art $100.00
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Total	$100.00
4” x 8” bricks can have up to 3 lines of text , 20 characters per line without clip art and 16 characters with clip art	$100.00