1300 W. Conway Rd. Harbor Springs, MI 49740  231-347-2396

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Brick Donation

*Required

Name & Address for Notification regarding your Gift (gift amount will not be included in notification)

Brick-Instructions to Complete Lines 1-3
The following 3 Lines are Limited to 15 alpha-numeric characters or spaces per Line--Bricks are $125 per brick--Please complete a separate form for each brick desired.