Paving the Way Into the Future!
Show your support for the Light Station
Restoration by purchasing
one or more commemorative bricks. Get them inscribed with your
name or to honor or memorialize someone special. The bricks
will be permanently displayed at the light station.
The cost of a 4" x 8" brick is $75 each or 3 for $200.
Inscriptions may be up to 3 lines, upper and lower case letters.
Maximum of 14 characters per line.
(Spaces, commas, etc. count as characters)
Simply print this page, fill out and mail!
Name:
_______________________________________________________ Address: _____________________________________________________ City/State/Zip: _________________________________________________ Phone# _________________ Email: _______________________________ |
Brick layout:
____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ |
Send your payment, with this form, to:
Light Station Restoration Fund
P.O. Box 491
Port Washington WI 53074
The Port Washington Historical Society/Light Station
Restoration is a 501 (3)c charitable organization.
Contributions are tax deductible as allowed by law.