Print this form using your browser’s print function. Then fill it out.
Include this form with your Invest in the Paragon Carousel form.
All brick orders make you a member automatically... Thank you!
Please note: All bricks will be placed randomly throughout the walkway. Special groupings can be ordered for bricks ordered at the same time for a cost of $5.00 per brick. The extra cost covers installation time for the special placement.
All orders will be confirmed by mail with your certificate. Please PRINT clearly. The engraving will be done exactly as you specify for characters. Special characters are $5.00 each (Special
characters are characters like hearts. Bullets and hyphens are normal characters.). Only certain characters can be engraved, so check with the office when ordering with special characters. All characters are in capitals only.
Logo Bricks must be reviewed to become an accepted order to insure we can engrave the
brick. Some logos are simply too complicated. The logo preparation is done by hand for this process.
If ordering more than two bricks, use a separate order sheet. If you have any questions about your order, please contact the office at 781-925-0472.
Brick Order #1 (4"x8")
Up to two lines for $75. For the third line add $25 for a total of $100.
Brick #1 Total:__________________
Brick Order #2 (4"x8")
Up to two lines for $75. For the third line add $25 for a total of $100.
Brick #2 Total:__________________
Brick Order #3 (8"x8")
Up to five lines for $250 (5 line bricks have standard character size and spacing. 7 lines can be ordered for 0.5" characters and spacing only.) Hand engraved logo requires a $500 deposit.
Brick #3 Total:__________________
Notes:Total Bricks ordered:__________________
Order Total $:__________________
| Name:________________________________________________________________________ |
| Address:________________________________________________________________________ |
| City:________________________________________________________________________ |
| State:____________________________________ |
| Zip:____________________________________ |
| Phone:____________________________________ |
| E-mail:____________________________________ |
| Credit Card (Visa, MC, Other):____________________________________ |
| Card Number:________________________________________________________________________ |
| Expiration Date:____________________________________ |
| Signature:________________________________________________________________________ |