City of Bondurant                          
                            Fire Department 
                            Brick Dedication

Donating or purchasing a brick will mean you are helping with the purchase of new equipment and needed supplies for the Bondurant Fire Department. Your donation or purchase will go for desks, tables, benches, a flag pole and much more at the new Public Safety Building.

 

This project is also meant to give the residents of Bondurant a sense of honor by adding a brick with

their name, a dedication, or meaningful quote.  This Brick Dedication is part of our new Public Safety Building. The engraved bricks will be used as a walking path around the flag pole and along the sidewalk in front of the new Public Safety facility.

 

The Brick: 4X8                                                                 The Brick: 8X8
13 Characters per line                                                 13 Characters per line
3 Line  total                                                                      6 Line total

                            


  4X8   1.___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___             
               
                  2.___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
               
                  3.___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___

  8X8   4.___   ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___   
               
                  5.___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___   
               
                  6.___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___

 

Name:

  Size      QT       Cost        Price                                Total

   4X8  _____   $30.00 = ___________                   

                                                                                     _________________

   8X8  _____   $60.00 = ___________

 

Phone:

 

I hereby acknowledge that I have read this application and that it is correct. The City reserves the right to monitor brick applications.

_______________________________________________________________

Sign Brick Purchaser                                                                 Date

 

 

Address: