Brick Order Form

Thank you for your donation to the Corpus Christi Catholic School Annual Fund! Your support of our school is greatly appreciated. We are happy to provide an engraved brick as our gift to you.
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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Phone Number Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Disciples of St. Michael Society ($100 - $499)
  4" X 8" brick with 2 lines of engraving (up to 20 characters per line.)
- Line 1: Please enter valid data.
- Line 2: Please enter valid data.
- Orange & White Ribbon Society ($500 and above)
  4" X 8" brick with 3 lines of engraving (up to 20 characters per line)
- Line 1: Please enter valid data.
- Line 2: Please enter valid data.
- Line 3: Please enter valid data.
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If you have any questions, please contact Stephanie Gillis, Director of PR & Development.

sgillis@CCSCatholic.com
251-342-5474, ext. 1105