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2. To celebrate the five-year anniversary of the Patriarche Park Playground, community members have the opportunity to purchase engraved brick pavers that will be installed at the entry of the plaza. Please fill out the following information, including the brick paver size, quantity and what you would like engraved on it. The deadline to submit a brick paver order form is Oct. 15 and the brick pavers will be installed at the park by Oct. 31. If you would like more than two brick pavers, please fill out an additional form.
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. ZIP*
15. Phone:*
16. Email:*
20. Two Brick Sizes Available:
22. 4" x 8" Brick - $100
    
23. Quantity:*
25. Wording for Brick 1 - Up to three lines, maximum 14 characters per line
26. Wording for Brick 2 - Up to three lines, maximum 14 characters per line
28. Line 1
29. Line 1
31. Line 2
32. Line 2
34. Line 3
35. Line 3
37. 8" x 8" Brick - $150
    
38. Quantity:*
40. Wording for Brick 1 - Up to four lines, maximum of 14 characters per line.
41. Wording for Brick 2 - Up to four lines, maximum of 14 characters per line.
43. Line 1
44. Line 1
46. Line 2
47. Line 2
49. Line 3
50. Line 3
52. Line 4
53. Line 4
57. Payment
    After submitting this form, you must remit payment by credit card or check. Your order will not be placed until payment is received. To pay by credit card, please contact Jane Stone at (517) 319-6809 or jstone@cityofeastlansing.com with the credit card information. To pay by check, please make checks payable to City of East Lansing and mail it to East Lansing Parks and Recreation Department, Attn:Jane Stone, 410 Abbot Road, East Lansing, MI 48823.
59. Questions?
    Contact Jane Stone at (517) 319-6809 or email jstone@cityofeastlansing.com
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61. 1. Receive an email copy of this form.
62. Email address

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63. Submit

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