Boler's Inn Memory Walkway Brick Order Form
I would like to purchase a BRICK in memory or in honor of
NAME:______________________________________________________________________________
to be placed in the Memory Walkway at Boler's Inn.
Each BRICK has 14 letters per line, maximum 2 line limit, as to ensure a brick that all will be able to read. The cost of each Brick is $35.00 and must be paid for before the Brick will be ordered and placed in the walkway.
To order, please print this form and mail with your $35 check made payable to "Boler's Inn" to the following address:
Boler's Inn Memory Walkway
100 Highway 494 East
Union, MS 39365
Inscription to be engraved on the Brick. (Please check your spelling and dates before mailing the order form.)
Line 1:______________________________________________________________________________
Line 2:______________________________________________________________________________
Ordered By:
Name:_______________________________________________________________________________
Address:_____________________________________________________________________________
Telephone:___________________________________________________________________________
E-Mail:______________________________________________________________________________
Thank You for your support of this project.
Boler's Inn Foundation