Order Form

Inscription Information __ Engrave my brick with my inscription only. __ Engrave my brick with my inscription and one of the following choices of artwork (circle one):

Each symbol uses some space. For a 4x8 brick you lose 4 spaces at the beginning of all three lines leaving only 16 spaces per line. For an 8x8 brick, you lose one complete line and only have 5 lines available for inscription. Please print your inscription below.

4x8 Brick There is a limit of 3 lines of 20 characters per line (including spaces) for each 4x8 brick or bench plaque.

8x8 Brick You may use up to 6 lines of 20 characters per line (including spaces) if purchasing an 8x8 brick.

Name ________________________________		Enclosed is my check for $ ______________ Make check payable to: Cabrillo Education Foundation
Address ______________________________
City _________________________State_____
Zip _______Telephone___________________		VISA   MASTERCARD   (circle one)
Email _________________________________		Account # _____________________________
		Expiration date ____________
____No. 4x8 bricks @ $150	$_______	Cardholder signature
____No. 8x8 bricks @ $350	$_______	_____________________________________
____No. benches @ $2,500	$_______	Return to: Cabrillo Education Foundation Buy a Brick Program PO Box 354 Half Moon Bay, CA 94019
Total	$_______

The bricks remain the sole property of Cabrillo Education Foundation (CEF). Bricks are installed on a first come basis at the sole discretion of CEF. Bricks may become worn or damaged due to natural causes without liability to CEF. CEF reserves the right to refuse inappropriate inscriptions. Bricks may be removed or relocated by CEF without liability for replacement at any time.