Engraved Brick Application

Lions Plaza at the Lions State Office Building
Offered through the Indiana Lions Foundation

Brick Options

Option 1: Standard 4x8 Brick

COST: $100.00 per brick, 3 lines maximum, 13 characters per line (including spaces)

Option 2: Large 8x8 Brick

COST: $250.00 per brick, 6 lines maximum (or 4 lines & Lions logo), 13 characters per line (including spaces)

Brick Fee Due with Application

Your Information

Name:

Address:

Club/District:

Phone #:

Logo: Yes No

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