Walk of Fame Brick Order Form 

         3 lines, 16 characters per line (including spaces)

     To buy a brick, please print this page, fill it out, and send it to the address below

                  Brick One         

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                 Brick Two         

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                   Brick Three         

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Name ______________________________________Phone ________________

Address _________________________________________________________

 Mail to:       Homes for the Homeless             Please enclose $30 per brick
                   PO Box 3081                             Make checks payable to:
                   Universal City, TX 78148          Homes for the Homeless

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