Memorial Brick - a Fundraiser - Clive Historical Society

Honor a special person or group or provide a lasting memory to a loved one by contributing a personalized engraved brick. Your $50 contribution will help pave our walkway that features both new and “old” bricks from the depot’s original location.

You may print out our Memorial Brick form from the sidebar and send a check for $50 or fill out the form below and pay with PayPal.

Make check payable to:

Clive Historical Society
Memorial Brick
PO Box 71262
Clive, IA 50325

For questions regarding the “Memorial Bricks,” please contact Mildred Swanson. Please put “Memorial Brick” in the subject line.

* Denotes a required field.
First Name:*
Last Name:*
Address*
Street Address Address Line 2 City State ZIP Code
Tele:*
Email:*
Message Section:*
The brick can be imprinted with three lines of up to 15 characters per line (including spaces). Example: HAROLD GRIMES FRANCES GRIMES 1973 - 1993 Please fill out your message below. The Clive Historical Society reserves the right to choose type size and arrange words to maintain balance & legibility.
»»» Once you've submitted this form, you will be redirected to a secure PayPal page to complete your purchase. You can choose to pay with either your PayPal account or a credit card if you do not have an account. Once we receive notification of the payment, you will be contacted.«««

Thank you for supporting the Clive Historical Society.
Captcha
To prevent spam, please complete the math challenge.
Email
This field is for validation purposes and should be left unchanged.