Cedar Crest College
Secure Order Form

Walkway 4"x8"Brick ($ 100 each)
Please place my brick in: (4"x8" only )
Miller Family Building Walkway
Administration Building Walkway
Curtis Hall Walkway
 
Please personalize the certificate as follows:
(example: Happy Birthday! Love Mom)
 
Inscription
(maximum 3 lines and 13 spaces per line):
On the Walkway Brick
Line 1
Line 2
Line 3
   
  This brick is a gift.
Please send the Certificate to me.
Please send the Certificate directly to
the recipient at the following address:

Recipient's Address  
 
   

This brick is for me.
Please send the Certificate to me.
Please do not send me a Certificate.

 

 


Paver Brick 12"x12" ($ 300 each)
  
Inscription
(maximum 7 lines and 19 spaces per line): (12"x12" only)		  
Line 1:
Line 2:
Line 3:
Line 4:
Line 5:
Line 6:
Line 7:
   

This brick is a gift.
Please send the Certificate to me.
Please send the Certificate directly to the recipient at the following address:

Recipient's Address  
 
   

This brick is for me.
Please send the Certificate to me.
Please do not send me a Certificate.

 

Seat at Samuel Theatre ($ 500 each)
In what section of the Theatre would you like to name your seat?
   
Inscription
(maximum 2 lines and 13 spaces per line):
Line1:
Line2:

 

Name a Bench ($ 1000 each)
Inscription
(maximum 2 lines and 13 spaces per line):
   
Line 1:
Line 2:
   
   


GENERAL INFORMATION
First Name: Last Name:
Address:
City: State: Zip:
Country:
Phone Number:
E-Mail Address:


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