FUND RAISER BRICK AND QUARRY TILE
Please circle your choice - complete form and mail with your payment to the address below.

4x8 Brick - $50
4x6 Quarry Tile - $50
6x6 Quarry Tile - $75
Up to 3 lines/20 characters per line including punctuation and spaces

8x8 Brick - $75
8x8 Quarry Tile - $100
12x12 Quarry tile - $125
Up to 6 lines/20 characters per line including punctuation and spaces

Name: ____________________________________
Mail Address: ________________________________
City/State: _____________________________________
Phone#: ________________________________________
Paid: _______Cash     ______________Check#

Mail to:
Fieldale Community Center . Box 312 . Marshall Way . Fieldale, VA 24089

Questions? Call 276-673-6836