Have a question? Give us a call: (302) 856-7958

Donate a Brick Form

                    Join the $125 Brick Club

of the Georgetown Public Library

     Please complete a form for each brick ordered

First Line {14 Characters}

I     I     I     I     I     I     I     I     I     I     I     I     I     I     I

Second Line (14 Characters)

I    I    I    I    I    I    I    I     I    I    I    I    I    I    I

Third Line (14 Characters)

I     I     I     I     I     I     I     I     I     I     I     I     I     I     I

14 Characters per line including spaces. Please use the ampersand (&} in place of "and" whenever possible. Right reserved to lay out the brick so it can be blasted and easily read.



Name   --------------



Address  --------------

Make checks payable and mail to: Friends of the Georgetown Public Library

123 West Pine St., Georgetown, DE 19947 or they may be dropped off at the


Phone  ---------------

Dates: Form received                                                    

Payment received                                                                                                Payment deposited                  

Payment type




Form faxed


Payment to Salisbury

Brick received





Brick laid


By Whom


Location of brick