IDAHO FALLEN FIREFIGHTER MEMORIAL

BRICK ORDER FORM

NAME: Click here to enter text.	DATE: Click here to enter a date.
ADDRESS: Click here to enter text.
CITY: Click here to enter text.	STATE: Click here to enter text.	ZIP: Click here to enter text.
PHONE: Click here to enter text.	EMAIL: Click here to enter text.
DEPARTMENT/AFFILIATION (if applicable): Click here to enter text.
☐ 4x8 BRICK $100	☐ 8x8 BRICK $200	☐ 8x8 BRICK WITH LOGO* $250

ENTER YOUR PERSONALIZED BRICK INSCRIPTION BELOW

4x8 BRICK - up to 3 lines of text, maximum 20 characters per line

1st LINE: Click here to enter text.

2nd LINE: Click here to enter text.

3rd LINE: Click here to enter text.

8x8 BRICK - up to 6 lines of text, maximum 20 characters per line

1st LINE: Click here to enter text.

2nd LINE: Click here to enter text.

3rd LINE: Click here to enter text.

4th LINE: Click here to enter text.

5th LINE: Click here to enter text.

6th LINE: Click here to enter text.

8x8 BRICK WITH LOGO* - up to 2 lines of text, maximum 20 characters per line

1st LINE: Click here to enter text.

2nd LINE: Click here to enter text.

**Logo must be emailed to smarkowski@cityofboise.org in one of the following formats: .ai, .eps, .jpg, .png, .tiff, .bmp, .gif**

Characters include all letters, numbers, punctuation marks, and blank spaces found on an English keyboard. Inscriptions will be automatically centered and engraved in UPPERCASE letters. Inscriptions that contain websites, phone numbers, and/or manifestos are not permitted. Discriminatory, political, offensive, or inappropriate messages as determined by the City of Boise will be declined and require a new inscription to be submitted.

Make check payable to Boise City Heritage Fund with IFFM on the memo line

Mail completed form and check to:

Boise Fire Department c/o IFFM

333 N. Mark Stall Place

Boise, ID 83704

For questions, call 208-570-6554 or email smarkowski@cityofboise.org.

100% of the proceeds will be designated for improvements and maintenance of the Idaho Fallen Firefighter Memorial.