DEDICATED BRICK APPLICATION

Your Name:                                                                                                            

Phone:                                                                                                                        

Fax:                                                                                                                        

Address:                                                                                                                 

City/State/Zip:                                                                                                        

Each brick purchased will be held at the office until the requested planter can be completed.

The Allen County Agricultural Society is currently replacing the old wooden planters located on the fairgrounds with new bricked planters. Most planters will hold approximately 45 dedicated bricks which can be sponsored by individuals or companies. To purchase a Dedicated Brick, print this form or contact the Allen County Fairgrounds for a form, complete and sign where indicated, and return with the sponsorship fee.

I/We, Sponsor, have read and hereby agree to the terms and conditions stated herein.

Sponsor Signature:                                                                                                     

Print Name:                                                                                                       

Date:                                                                                                                 

Allen County Agricultural Society

ORDER FORM

To participate in this unique experience, please complete this Order Form and the Application Agreement and return along with payment. Allen County Agricultural Society, 2750 Harding Hwy., Lima, OH 45804. (419-228-7141)

The bricks are 8" x 8" square. Each brick may contain pictures, logos and/or printed materials, and may contain names, numbers, logos, as requested with the final approval or denial of any message to be placed on the brick to be made by the Allen County Agricultural Society. The Allen County Agricultural Society has the final determination on the location to which any dedicated brick is placed.

The cost to sponsor a dedicated brick is $100.00. 

Enclosed Check or money order payable to: Allen County Agricultural Society

Check  Method of Payment:

VISA                            MasterCard                                    Discover                    

16 digit account number:                                                                

Expiration Date:                                                                            

Signature:                                                                                      

DO YOU WISH TO INCLUDE ALLEN COUNTY FAIR LOGO? 

YES                          NO                

PREFERRED CHOICE OF PLANTER LOCATION - CIRCLE ONE

SHOW ARENA - SOUTH		SWINE BARN #1
SHEEP/HORSE BARN		GOAT BARN
BEEF BARN #2		ANY LOCATION

Please attach a copy of your design and inscription to this application. Call the fair office with any questions, 419-228-7141.