Brick Order Form


Bricks purchased by: _________________________________________

Mailing Address_______________________________________________

City, State, Zip________________________________________________

Order Date_____________ Phone________________________________

Number of bricks purchased: __________________________________

Return this form with your check made payable to:

City RR Depot Museum, P.O. Box: 7220, McComb, MS 39649

 

 

Please print clearly
Duplicate this form as necessary to order additional bricks

 

Small Brick  $50 Each
4 X 8 inches - 3 lines - 16 spaces per line

                               
                               
                               

Large Brick  $100 Each
8 X 8 inches - 6 lines - 16 spaces per line

                               
                               
                               
                               
                               
                               

 

 

 

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