Genesis 50th Anniversary Engraved Brick Order Form

BE A LASTING PART OF
THE GENESIS 50TH ANNIVERSARY

PURCHASE AN ENGRAVED BRICK FOR THE GENESIS CELEBRATION COURTYARD

In recognition of the 50 years of Genesis Vision that:

“By daily embracing mutual trust and respect, we partner with God and one another to heal a broken world."

The Genesis Anniversary Committee is replacing the paving stones in the courtyard adjacent to the Social Hall ramp with engraved bricks recognizing members of the congregations of St. Clare’s and Temple Beth Emeth.

Genesis 50th Anniversary Engraved Brick Order Form

BE A LASTING PART OF THE GENESIS 50TH ANNIVERSARY

PURCHASE AN ENGRAVED BRICK FOR THE GENESIS CELEBRATION COURTYARD

In recognition of the 50 years of Genesis Vision that:

“By daily embracing mutual trust and respect, we partner with God and one another to heal a broken world”

The Genesis Anniversary Committee is replacing the paving stones in the courtyard adjacent to the Social Hall ramp with engraved bricks recognizing members of the congregations of St. Clare’s and Temple Beth Emeth.

* First Name

* Last Name

* Email

* Phone

* I would like to purchase:

Please fill out the form below and specify your dedication in up to 3 lines of 14 characters each*.

*If required, additional characters above the nominal design can be requested at $1 each (including spaces) by contacting Linda Klimach lklimach@comcast.net

Line 1:

14 character max

Line 2:

14 character max

Line 3:

14 character max

Line 1 (brick2):

14 character max

Line 2 (brick 2):

14 character max

Line 3 (brick 2):

14 character max

Notes/Comments:

Amount Due:

Genesis 50th Anniversary Engraved Brick Dedication

Genesis 50th Anniversary Engraved Brick Order Form

BE A LASTING PART OF THE GENESIS 50TH ANNIVERSARY

Genesis 50th Anniversary Engraved Brick Order Form

BE A LASTING PART OF THE GENESIS 50TH ANNIVERSARY

Please fill out the form below and specify your dedication in up to 3 lines of 14 characters each*.

BE A LASTING PART OF
THE GENESIS 50TH ANNIVERSARY