FMBS 1 web

.......FMBS 1A.....web.....Downloaded from www.lancs-fusiliers.co.uk

The Fusiliers Museum, Lancashire
Buy a Brick Appeal.
Please complete Forms FMBS 1A & FMBS 1B and return them, with your cheque, to the address below

Buy a Brick Appeal
Fusiliers Museum Lancashire
Moss Street
Bury
BL9 0DF

Number of Bricks Required:-

Name of Applicant _________________________________

Address of Applicant: (please note this is purely for the information of administering the brick scheme and will not be used for any other purpose)

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Post Code __________Telephone No : _____________

Date of Application ____________________

Please make cheques payable to: .....Fusiliers Museum Appeal

For Office Use.

Staff Member: _________________________________________________________

FMBS 3 Receipt Number: ___________Brick Numbers_____________________

Remarks_________________________________________________________
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The Fusiliers Museum, Lancashire
Buy a Brick Appeal.
Please print your message(s) in the box(s) below, 30 words per brick maximum.

Brick 1 *Brick Dedicated to___________________________ Message _____________________________________ _____________________________________ _____________________________________ _____________________________________	Brick 2 *Brick Dedicated to___________________________ Message _____________________________________ _____________________________________ _____________________________________ _____________________________________
Brick 3 *Brick Dedicated to___________________________ Message _____________________________________ _____________________________________ _____________________________________ _____________________________________	Brick 4 *Brick Dedicated to___________________________ Message _____________________________________ _____________________________________ _____________________________________ _____________________________________
Brick 5 *Brick Dedicated to___________________________ Message _____________________________________ _____________________________________ _____________________________________ _____________________________________	Brick 6 *Brick Dedicated to___________________________ Message _____________________________________ _____________________________________ _____________________________________ _____________________________________

Form FMBS 1B web
* The Brick Dedication will be the name on the Brick and certificate

Please send BOTH these forms to the address on FMBS 1A