BUY-A-BRICK FORM

0 Items

In the box below, please fill in the name or phrase you wish to have engraved on your 4x8 brick. Spaces and periods are considered as letters, and you are allowed a total of 21 letters.
  
Name
Phone
Address_1
Address_2
City   State      Zip
Email

Letters To Be Engraved



ATTENTION
MAIL-IN
REGISTRANTS
:


Print clearly and use all capital letters.

Return this form
with payment to:

Flat Rock AME Church
Attn: Bricks Campaign
148 Chapel Hill Rd.
Fayetteville, GA 30214

Payment Details:

1 Brick(s) @ $30.00/ea. Total Amount Due $
       

Payment Methods:

PayPal, Credit Card, Money Order, Cashier's Bank Check, Personal Check, or Business/Organization Check. If you have any questions, please contact us by phone at 678/561-8487, or email: support@flatrockamechurch.org.

Registration Policies:

Cancellation/Refund Policy: You may cancel your order for a full refund within ( ) days of purchase. Refund requests must be made in writing, via the following email address: bricks@flatrockamechurch.org.

Click "SEND" to submit form and process payment: