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.