Order NCYC Paver Stones by Check

Print this page with your browsers print button and mail your form along with your check

Application For Paver Stones
NCYC Ordering Instructions For Paver Stones
8 x 8 Paver Stone Costs $125.00
Paver Stones Must Be Paid For Before Ordering. Make Checks Payable To NCYC or pay online with credit card
Paver Stones Are For - Members, Spouse and Their Children Only.
Deadline For New Orders July 30, 2009

First Name

Last Name

Street Address

City State Zip Code

Phone

A combination of 14 letters, numbers, or spaces per line.

All Lettering Will Be Capitalized and Centered On Paver Stone.

Line 1

Line 2

Line 3

Line 4

Line 5

NCYC Board Of Directors Will Have Final Approval Of Applications Before Paver Stones Are Made.

To return orders by US mail with your check mail to:

Bob Swan

9611 Anchor Dr.

Algonac, MI 48001

Home Ph. 810-512-4532

Cell - 586-615-2983