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• Smokedealers84
___ 4”x8” (maximum 14 characters per line, 3 lines) $100.00
___ 8”x8” (maximum 14 characters per line, 6 lines) $250.00
___ 8”x16” (maximum 14 characters per line, 6 lines) $500.00
___ 16”x16” (maximum 14 characters per line, 12 lines) $1000.00
(company logos available on 8”x16” and 16”x16” bricks for an additional fee)
step 2. clearly print the words you would like engraved on your brick next to the appropriate line number.
keep in mind the maximum number of characters and lines for your selected brick size.
all lines will be centered. spaces and punctuation count as characters.
please print legibly.
any order deemed inappropriate will be declined.
step 3. ordered by:
name:__________________________________
address:_________________________________
city:________________________ state:____ zip:__________
phone:__________________(only if questions arise about your order)
to place your order mail this completed form with payment to:
john walker - american huey 369 inc.
209 s broadway
peru, in 46970
step 4. >american huey 369 inc./gift brick
or include your credit card# ______-______-______-______ exp.______
3 digit # _____(back of card)
visa mastercard discover (we do not accept american express)
visa mastercard discover (we do not accept american express)
signature________________________________________
(credit card payments will be sent a receipt from american huey 369 inc. in 2-3 weeks)
your donation is tax deductible.
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