Download presentation
Presentation is loading. Please wait.
Published byRoss Cobb Modified over 8 years ago
1
AFD MEMORIAL BRICK SPONSORSHIP FORM PLEASE PRINT CLEARLY AND PUT ONE LETTER IN EACH BOX. ALSO SPACES COUNT AS A CHARACTER, SO PLEASE LEAVE A BOX BLANK BETWEEN WORDS Please check here if you would like to sponsor a memorial brick in the honor of a departed AFD member. NAME: _________________________________ ADDRESS: _________________________________ _________________________________ PHONE: _________________________________ Please send form and check Payable to: AFD Memorial Fund 55 West Oak Street Amityville, NY 11701 Amount enclosed: Brick:$ 200.00 Departed Member Brick: $ 75.00 In lieu of a brick, please accept a donation in the amount of: __________ Total enclosed: __________
2
DEPARTED MEMBER BRICK SPONSORSHIP FORM NAME: _________________________________ ADDRESS: _________________________________ _________________________________ PHONE: _________________________________ Please send form and check Payable to: AFD Memorial Fund 55 West Oak Street Amityville, NY 11701 Amount enclosed: Brick:$ 100 In lieu of a brick, please accept a donation in the amount of: __________ Total enclosed: __________ Please note there will be only one brick for each member (Please put a single letter in each box, Line 1 First Name, Line 2 Last Name) LINE 3: Place a check mark in the appropriate box Rank: (if applicable) Ex-Chief Ex-Captain Company: (Please select only one Company) Hose Co. 1 Hose Co. 2 Hose Co. 3 Hose Co. 4 H & L Co. 1 Fire Police Ladies Auxiliary
3
AFD MEMORIAL CORPORATE BRICK SPONSORSHIP FORM PLEASE PRINT CLEARLY AND PUT ONE LETTER IN EACH BOX. ALSO SPACES COUNT AS A CHARACTER, SO PLEASE LEAVE A BOX BLANK BETWEEN WORDS Please check here if you would like to sponsor a memorial brick in the honor of a departed AFD member. NAME: _________________________________ ADDRESS: _________________________________ _________________________________ PHONE: _________________________________ Please send form and check Payable to: AFD Memorial Fund 55 West Oak Street Amityville, NY 11701 Amount enclosed: Brick:$ 400.00 Departed Member Brick: $ 75.00 In lieu of a brick, please accept a donation in the amount of: __________ Total enclosed: __________
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.