Mount Wesley
FOOTSTEPS IN FAITH
Engraved Pavestone Order Form
Payment Information
: Make checks and money orders payable Southwest Texas Conference United Methodist Church, indicate "for Mount Wesley Pavestone" on check, and mail to:

Mount Wesley Conference Center, 610 Methodist Encampment Road, Kerrville, Texas 78028

____ @ $50.00 = ___________
No of Bricks
_______ Check# _________
_______ Money Order
_______ Cash

Individual to Contact for Verification of Information

Name: __________________________________________Work Phone: ( __)_________
Address:
________________________________________Home Phone: (___)_________
                                 Street                        City                                    Zip
Name of Indiv./Org. to be identified as purchaser/donor: ________________________________________________________________
Indiv./Org. to whom Certificate should be mailed: _________________________________________________________________

Address
:                                                                                                   
                                          Street                                                       City                               Zip
Pavestone Engraving InstructionsThe 4" x 8" pavestone will accommodate 3 lines of 14 characters each. Fill in the grid, leaving a space between the words; don't worry about centering the text the engraver will do that!   Make sure all abbreviations communicate your true intent. Your message must fit --  no exceptions!

 

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14

A

                           

B

                           

C

                           

--------------------------------------------------------------------------------------------------------------
(Detach and retain for your records)
Mount Wesley Engraved Pavestone

Date Paid ____________ Payment Tendered $ __________

Check No.___________ Cash ____________ Money Order ________

 

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