• PRINT clearly
• Messages on bricks will be centered automatically
• Only one letter or form of punctuation per block
• Spaces have to be left between words and count in the overall total
• Up to 4 lines with 15 spaces per line may be used
• All messages are in capital letters ONLY
• Mail this form or a copy to:
Camp Moore
P. O. Box 25
Tangipahoa, LA 70465
• Checks or money orders should be made out to “Camp Moore”
• There is no limit on the number of bricks you may purchase
• If you need additional information, please call Camp Moore at (985) 229-2438 or please email Camp Moore at manager@campmoorela.com
1. Bricks are ordered in January, April and September every year. You will be notified via the Friends of Camp Moore Newsletter as to the actual installation date for viewing of the Volunteer Memorial Courtyard.
2. Please note the change in the form. This is the ONLY form now allowed for brick orders (1/1/12)
3. You will receive a certificate documenting your memorial brick in honor of the person/organization that you have chosen and an image of the brick when completed
PLEASE PRINT
Customer Name___________________________________________
Address_____________________________ City_________________
State_________ Zip____________
Email____________________________________________________
Pay by Credit Card by filling in information below:
Card No._____________________________________V Code______
Expires___________ Signature_______________________________
OR, enclosed is your check or money order for $60.00 for each brick
orderedFill in the spaces with your proposed wording
-IMPORTANT!- INCLUDE SPACES BETWEEN WORDS!
"Let it never be said that their Sons and Daughters in these Southern States have forgotten their noble example."
