Buy-a-Bric k - Columbia Association · CA’s Spec ial 50th Birthday placement at Do wntown Columbia Lakefront CA is once again hosting its Buy-a-Brick program in honor of the 50th

CA’s Special50th Birthdayplacement at Downtown ColumbiaLakefrontCA is once again hostingits Buy-a-Brick programin honor of the 50thBirthday Celebration in 2017. A section of the walkway at theDowntown ColumbiaLakefront will bereserved for bricksplaced around a largepaver that saysColumbia Maryland 50(see image above).

Complete this form and mail it with payment to the address below, or bring it to Columbia AssociationHeadquarters, Customer and Member Service Center.Columbia AssociationBuy-a-Brick Program6310 Hillside CourtColumbia, MD 21046The cutoff for purchasing bricks that will be placed in the walkway in summer2017 is Feb 24, 2017. No purchases will be accepted after that date.

For additional information about the Buy-a-Brick program, please contact Christina Pierre, 410-423-4102 or [email protected], or visitthe Customer and Member ServiceCenter at the above address.

Buy-a-BrickORDER FORM

Your name

Your address

City, State, Zip

Your email address (Mandatory for confirmation of purchase and follow-up after placement.)

Please check one: o Special 50th Birthday Section $100 o Other Section $75You may choose one, two or three lines of text — the cost is the same.

First line: (limit 15 characters; spaces count as characters)

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Second line: (limit 15 characters; spaces count as characters)

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Third line: (limit 15 characters; spaces count as characters)

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o Check enclosed for $___________________o Charge my credit card: o Discover o Visa o Mastercard o American Express

Credit card number

Expiration date CVV (3 digits)

Name as it appears on credit card

Address associated with credit card

Signature authorizing this charge to your credit card account

Payment will be processed at time of order. You will be notified after your order has been processed and after placement in summer 2017. You may download a reservationcertificate from ColumbiaAssociation.org/brick for gift-giving purposes.

Please fill out one form for eachbrick purchased.If you purchase multiplebricks, we cannot guarantee that they will be placed next to each other.