Buy a Brick to Support Medalta

The future of Medalta depends heavily on the support of the community members we touch. Please consider buying a brick to support the creativity, community, heritage, and learning that engulfs the Historic Clay District.

First Name *

Last Name *

Phone Number *

Email Address *

Mailing Address *

City *

Province/State *

Country *

Postal Code *

Brick Type Purchased

	$2,5000 Brick
	$1,000 Brick
	$500 Brick

What would you like the first line of your brick to say? (Maximum of 18 characters per line including spaces and punctuation) *

What would you like the second line of your brick to say? (Maximum of 18 characters per line including spaces and punctuation)

I would like to make an additional donation to the Friends of Medalta Society (enter dollar amount).