Remembrance Brick Order Form

Remembrance bricks that will surround the base of the angel may be purchased
for $100.00 or more. Each brick includes up to 3 lines of engraving
with as many as 20 characters, alpha or numeric, per line.
Spaces, dashes, etc. count as a character.
Your lines will automatically be spaced and centered by the engraver.
Brick orders will be processed on a regular basis.

Purchased by: ______________________________________________________________

Address: __________________________________________________________________

City, State, Zip: _____________________________________________________________

Phone Number: _____________________________________________________________

Make check payable to: GISOC, Angel of Hope Fund

Print this form. Fill in the information and send it with your payment to:

GISOC
Angel of Hope Fund
P.O. Box 148
Tustin, CA 92781