Office Use Only. Order Number:

 

Laser Engraved Brick Order Form

Customer Information

 

Purchased By: _________________________________ Phone: _____________________ E-mail: _____________________________________

 

Address: _________________________________________ City: _________________________ State & Zip: ____________

Settler Area Only What year was this family in Valley View? _______________________

BRICK INFORMATION

Information in each column. Standards are in bold.

Brick

Blend

Brick

Name

Brick

Size

Font Style &

Font Size

Alignment

Horizontal

 

Vertical

612672

English Edge Red

4 x 8

VERMARCO 5/8

Center

Center

 

Instructions: There can be up to four lines on a brick. There is a maximum of 15 spaces allowed per line. Each letter, number, space, comma, etc. is counted as a space.

Complete the form starting with the box on the lefthand side and enter what you wish to be inscribed. We will have the submittal centered on each line.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Each inscribed brick is $50.00

Make checks payable to: Keep Valley View Beautiful Mail to: Norman Newton, 307 Monterrey Trail, Valley View, TX 76272