Memorial Paver Order Form in PDF Format for Printing
Please complete the bottom portion and mail to PBCC 

community center memorial 3 page 001

Honor the Memory of a Loved One

Celebrate the life of someone dear to you by purchasing a brick to be placed in PBCC’s Community Memorial Paver Area. Remember a loved one who brought light to your life, a friend who loved nature, or someone with whom you shared precious moments. As you honor the memory of your loved one, your gift will help to maintain our paver area.

To purchase an engraved brick for placement in the memorial paver area, please complete the form front side and mail to  Powell Butte Community Center, P O Box 87, Powell Butte, Or 97753

• All bricks are 6”X 8”

• 3 lines of print with a maximum of 16 characters per line including spaces and punctuation

• $50.00 for each brick

• Bricks will be engraved as a group and will be placed in the memorial paver site
  randomly by the PBCC Board Committee.

• Bricks are for memorial use only

• For assistance and suggestions on wording, please see below or feel free to contact the PBCC at (541) 419-8061

• PLEASE PRINT INFORMATION EXACTLY AS YOU WOULD LIKE IT TO APPEAR, INCLUDING SPACES AND PUNCTUATION, • ALL CAPITAL LETTERS

• PAYMENT MUST BE MADE WHEN ORDER IS PLACED. (Checks payable to Powell Butte Community Center

SUGGESTED WORDING SAMPLES

(Every letter, every space between words, and every punctuation mark counts as one character in the line. 16 characters per line allowed.)

IN MEMORY (ex. “IN_MEMORY” is 8 letters, 1 space = 9 characters);  LOVING MEMORY (13); REST IN PEACE (13): SAFELY HOME (11)IN GOD’S CARE (13);

ALWAYS LOVED & (14) REMEMBERED (10); ALWAYS IN OUR (13) MEMORIES (8); LOVED FOREVER (13)