Order Your Highlands Natural Pool Brick!

Become Part of the History of the Highlands Natural Pool

Purchase a 4x8" engraved, permanently sealed brick paver to be installed in the Highlands Natural Pool

entrance walkway. To be included in this fundraising effort, please complete the form below. This is a great opportunity for you to honor...

Someone who deserved recognition for past contributions to the pool.
Yourself!
The memory of a loved one.
A son, daughter, parents, grandparents, family members.
A Friend.
Birthdays, anniversaries, commencements, and other occasions that have special meaning to you.

O R D E R F O R M

Lettering:		Three lines of text with up to 13 "characters" per line.
		("characters" include numbers, letters, spaces, symbols & punctuation)
Cost:		$75 for each brick, $5 extra for each symbol. (Send your tax deductible check
		made payable to the Highlands Natural Pool)
Mail to:		Highlands Natural Pool, 180 Snake Den Road, Ringwood, NJ 07456
Questions:		Call 973-835-4299

I wish to order ____ engraved brick(s) @ $75.00 each. Please add ____ symbols @ $5 per symbol.
Total amount enclosed $ _________ (One order form per brick order – copy this form for additional orders)

Name:	_________________________________________E-Mail:______________________________
Address:	_____________________________________________________________________________
City:	____________________________State:____ Zip:__________Phone:____________________

Fill in the boxes below with your desired text. Capital letters only. Only one character or space per box. Punctuation counts as characters. Print clearly and check spelling for accuracy. Text will automatically be centered on the brick:

Thank you for helping to pave the way for the Highlands Natural Pool's future success!

The Highlands Natural Pool is a 501(c)3 non-profit organization and contributions are tax-deductible to the extent allowed by law.