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Name Address City Zip Phone E-Mail Check Enclosed payable to Special Olympics Iowa Please charge to my VISA MasterCard Discover Credit Card Card Exp. Date 3- Digit Code Signature 4 x8 Brick Paver 3 Lines 14 Spaces 8 x8 Granite Paver 6 Lines 28 Spaces COMPLETE INFORMATION FOR BRICK/PAVERS ON REVERSE SIDE. ORDER FORM 8 X 12 Granite Paver 600 14 Lines 9 Spaces Vert. YES I/we wish to purchase an engraved brick or paver in the Special Olympics Iowa Walkway of Champions. Inside the ribbon is the...
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