Vision Oz: Yellow Brick Road Brick Order

	DON'T JUST FOLLOW THE YELLOW BRICK ROAD... HELP PAVE IT!
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PHASE II: Each personalized yellow engraved brick (4x8") will become part of the permanent walkway running between the Friendship House and the Senior Center. Special limited edition engraved "Yellow Brick Road Wamego KS" bricks (4x8") may be purchased as a souvenir or gift to take home [click here to see sample brick] Funding will help pave the walkway as well as support future Oz-themed projects to help make Wamego the number one tourist destination in Kansas. All donations are tax-deductible as a charitable contribution. Click here for Frequently Asked Questions about the YBR.
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****Contact information in bold is required:


Name:

Company:

Address:

City:	State: Zip:

Telephone:	Fax: (Please include area code; with or without punctuation)

E-mail:

How did you hear about the YBR?

Text-Only Engraved Bricks ...... $50.00 per brick [3-line limit; 16 characters per line, including spaces; maximum 48 characters]
	Brick 1 text: Brick 2 text: Brick 3 text: Brick 4 text:

Text Plus Logo Engraved Bricks ...... $75.00 per brick
	Brick 1 text: Brick 2 text: Brick 3 text: Brick 4 text: Click here to upload your logo (this will open a popup window)

Limited Edition "Yellow Brick Road - Wamego KS" Bricks An additional $15 s/h charge per brick will be added to each brick ordered
Enter quantity: ...	$25.00 Yellow Brick Road Brick (with purchase of text-only or logo engraved brick) $50.00 Yellow Brick Road Brick (w/out purchase of engraved brick)

Additional contribution to Vision Oz Fund
	(Do not use commas or dollar signs; ex. 1000.00 or 50.00 or 25.25)

* ATTENTION: After clicking the "Submit" button below, you will be taken to a secure server where you can pay by Credit or Debit Card. Thank you!