Olde Mill Impressions -- Engraved Brick Order Form

Brick Color Choices:			CUSTOM ENGRAVED BRICK
Brown	Tan	Charcoal Gray	After clicking on the link below, you will need to fill in your order as follows. Please write your desired text EXACTLY as it will appear on your brick. We will arrange it in up to 3 lines of text, with no more than 14 letters or spaces on each line. Please also include below your text, in paratheses, the color choise and font choice as shown here at left. <<Order Form>Order a Custom Engraved Brick
Total Amount Due With Order:
Number of Bricks Ordered:
@ $35.00 each:
Shipping & Handling $6.00 each:
PA Residents 6% Sales Tax:
TOTAL DUE:

Limestone Gray

Quarry Red

Red 15

Font Style Choices:

NOTE: Your phone number and e-mail address will be kept strictly confidential,
and will only be used to contact you for customer service related issues. Shipped only to the contiguous 48 states.