Morristown Gateway Museum
Engraved Memorial Brick Fundraiser 

Join us in becoming a permanent part at the museum

• Your brick may be inscribed with your family name
• It can memorialize or honor a loved one
• It can commemorate a special date or event

A 4 inch by 8 inch brick costs $60 and allows up to 3 lines of engraving up to 14 characters per line.

Purchased by:

Name:
address:
City:                            State:                     Zip
Telephone:


Please print legibly- spaces, numbers and letters count

_ _ _ _ _ _ _ _ _ _ _ _ _  _  Line 1

_ _ _ _ _ _ _ _ _ _ _ _ _ _   Line 2

_ _ _ _ _ _ _ _ _ _ _ _ _ _   Line 3

Please return completed form along with a check payable to:

Morristown Gateway Museum
PO Box 231
Morristown, NY 13664