Commemorative Brick Form
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Name *
Address *
City, State, Zip *
Phone *
Email *
I authorize this transaction for the purchase of a Commemorative Brick from The Hamlet Depot and Museums. If you agree, please type your name and date below to be considered as an electronic signature. Thank you. *
If you are purchasing using a CARD, please use CLICK HERE. Once there, insert the amount of $90 for members or $100 for non-members. BE SURE TO SELECT ONE-TIME BEFORE COMPLETING TRANSACTION!!! THIS WILL PREVENT YOU FROM BEING CHARGED MONTHLY!!! 
If you would like to pay by CHECK please make payable to Hamlet Historic Depot, Inc. and mail to 2 West Main Street, Hamlet, NC, 28345.
Please be honest as we will be cross checking these with our membership list.
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Please put EXACTLY what you would like to appear on the brick. There are only 3 LINES on the black and a MAXIMUM of 20 CHARACTERS PER LINE: this includes punctuation marks and spaces.

Slight variation in bricks may occur as a result of the brick used and the supplier. Thank you for your Commemorative Brick order for the Hamlet Historic Depot.
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