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SAMPLE:
M A T T H E W _ B U X T O N _
O K E E C H O B E E _ 2 3 7 _
_ J U N I O R _ W A R D E N _
_ _ _ _ - 2 0 0 5 - _ _ _ _ _
Print out the above or make your own form with 4 lines of 15 characters max, fill
in your own information, be sure to note your name, address and phone number so we can ask
any necessary questions regarding your brick and enclose a check for $50.00 Donation
Mail to:
Okeechobee Lodge No. 237 F&AM
107 NW 5th Avenue
Okeechobee, Florida 34974
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