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HomeMy WebLinkAboutRequest FormName Phone( 1 Address (Street, City/State/Zip Code) Email Address Number of Bricks @ $50.00 per brick Please Make Check Payable to: City of Sebastian .If ordering more than one brick, please include the brick engraving information on a separate piece of paper Mail Order Form & Check To: City of Sebastian, Attn: Community Development, 1225 Main Street, Sebastian, FL 32958 ---Or Come In Person to Pay With Cash or Credit Card --- BRICK ENGRAVING: Maximum of 3 lines & 20 characters per line (including spaces & punctuation) All Letters M[I.S I be capiralized and text will be conte -ed automatically Preferred Area of Placement O Riverview Clock Tower ElVeterans Memorial O No Preference I r/e am jor.bal ve cannot place hoicks in specific speas or,gaaranfee placement in specfe area. A# bnekr wll be plated in andiable r(wu. If you have any questions regarding the order form, or the program in general, contact Margarita Hernandez at 772-228-7054.