Brick Purchase Form

Christ Church School Commemorative Brick

Leave a lasting legacy with the purchase of a commemorative brick. The bricks become part of the walkway leading to the playground and all orders receive a certificate with the inscription - perfect to give as a gift or keep as a memento.

Please fill out one form per brick ordered.
Cost is $200.00 each.

All orders must be received by May 31 each year, to be installed during the summer.

STEP 1 - Download Form

Download the order form and write out the message you would like inscribed on the brick.
Brick Order Form

STEP 2 - Upload Form & Payment

Once your form is filled out, upload a picture or scanned image.

Upload Completed Form*

(doc, docx, jpeg, jpg, pdf, png)

First Name*

Last Name*

Address*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Phone Number* - -

Method of Payment*Credit Card (+$200.00)

If paying by check, please make out to Christ Church School and include "Brick Purchase" in the memo line.

Amount$200.00

I would like to pay for the credit card processing fees.

Subtotal: $

Fees: $

Grand Total: $

Payment Method:*

Payment Notes/Additional Info:

Name Associated with Payment:*

Email Associated with Payment:*

Pay with:*

Send Myself a Copy

Thank you for choosing to leave your mark on Christ Church School! Funds collected through brick purchases go directly to benefit our students and teachers through the Annual Fund.