Brick Order Form

In 1948, Lenora McLeish had a dream: to organize a band for young musicians of Licking County that would broaden their musical talents, be a wholesome activity for the summer months, and bring another performing group to the area.

The Licking County 4H Band would like to honor Mac and Cork McLeish for their dream that created the 4H Band we know and love. The band plans to show tribute to Mac and Cork by building each of them a memorial in front of Tara. An alumni walkway will help fund the memorials as well as honor our alumni. Alumni and current band members can buy a brick for a minimum of $25.00 (donations exceeding this are happily accepted!). This will include your name, instrument, or leadership position in the band, etc, being imprinted onto the brick. Please fill out the form below and return to Dannette Morehouse or mail to the address listed below.

15 CHARACTERS PER LINE (INCLUDES SPACES, 3 LINES MAXIMUM) PLEASE PRINT CLEARLY

NAME: _________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Amount enclosed: ______________________ Phone Number: _______________________

MAKE CHECKS PAYABLE TO:
THE LICKING COUNTY 4H BAND
522 KIBLER AVENUE
NEWARK, OHIO 43055