YES! Engrave my name into Darien History with a personalized Darien Lions Club Pavilion Patio Brick!
City State Zip
To order your brick(s) today, fill out and detach the order form and mail it with your payment to:
Darien Lions Foundation1702 Plainfield Rd.
Darien, IL 60561
□ Include Check or Money Order. Do not send cash.
to: Darien Lions Foundation.
Simply check off the size of brick(s) you are ordering, and print the information exactly as you would like it to appear. Spaces and punctuation marks count as characters.
and crests are not
□ 4” x 8” Standard Size: $100
Max. 21 spaces, 3 lines
□ 8” x 8” Standard Size: $150
Max. 21 spaces, 5 lines
□ Check here if a corporate logo or family crest is requested. (You will be notified of additional cost that will be required to create the logo.)
Thank you for your donation!
NOTE: Use your browser to print this form and fill in all required information. Mail to the Foundation’s P.O. Box