Leesport, PA · Berks County
Legacy Wall Brick Order Form
Leesport residents, families, and businesses use this form to order a personalized brick for the Leesport Legacy Wall and provide engraving and contact details.
What this form is
The form lets you reserve a 4” x 8” or 8” x 8” brick for the Leesport Legacy Wall, with engraving limits listed for each size. It asks for your name, address, phone, city, state, ZIP code, email, and engraving text. The form lists prices of $75 and $150 and asks buyers to make checks payable to Leesport Recreation.
Who needs it
Anyone who wants to purchase a personalized brick for the Leesport Legacy Wall should complete the form and provide the requested engraving and contact information.
How to submit it
Make your check payable to Leesport Recreation and mail the order to PO Box 77, Leesport, PA 19533.
About notarization
This form is signed without a notary; it contains no notarized or sworn attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Leesport Legacy Wall Brick Order Form.
- 2
Complete The Order
Choose a brick size, enter your engraving, and provide the requested contact information.
- 3
Prepare Your Check
Make your check payable to Leesport Recreation.
- 4
Mail The Order
Mail the form and check to PO Box 77, Leesport, PA 19533.
Frequently asked questions
- What does the Legacy Wall Brick Order Form do?
- It lets you reserve a personalized brick for the Leesport Legacy Wall and provide your contact information and requested engraving.
- How do I submit the Legacy Wall Brick Order Form?
- Make your check payable to Leesport Recreation and mail the form and check to PO Box 77, Leesport, PA 19533.
- Do I need a notary for the Legacy Wall Brick Order Form?
- No. This form has no notary block or notarized attachment; the signer just signs and dates it.
- What brick sizes and prices are listed?
- The form lists a 4” x 8” brick for $75 and an 8” x 8” brick for $150, with different engraving limits for each size.