Donate Bricks - The Lighthouse of Houston

Donate Bricks Form

This donation is dedicated to: for a total donation of $0.00

Bricks are 4 inches, by 8 inches, by 3 inches.

Print space for each brick is limited to 2 lines, 16 characters each - 32 characters total. Type the wording for your brick exactly as you would like it engraved in the grid below using capital letters and numbers. Include punctuation and spaces as characters, and leave a blank between each word.

Bricks

Brick 1

Brick 2

Brick 3

Brick 4

Brick 5

Brick 6

Brick 7

Brick 8

Brick 9

Brick 10

Brick 11

Brick 12

Brick 13

Brick 14

Brick 15

Brick 16

Brick 17

Brick 18

Brick 19

Brick 20

Brick 21

Brick 22

Brick 23

Brick 24

Brick 25

Brick 26

Brick 27

Brick 28

Brick 29

Brick 30

Brick 31

Brick 32

Brick 33

Brick 34

Brick 35

Brick 36

Donated By:

First Name*

Last Name*

Phone*

Email*

Address*

City*

State*

Zip*

Gift Letter

This is a gift, please send an acknowledgement card.

Recipient

First Name

Last Name

Address*

City*

State*

Zip*

Donation Total: $0.00