Welcome to EL JEBEL SHRINE
THE DESERT OF COLORADO THE OASIS OF DENVER
"No Man Ever Stood So Tall As When He Stooped To Help A Child"

EL JEBEL PLAZA

LEVEL	AMOUNT	BRICK	ENGRAVING
BRONZE	$100.00	4”x8” #32 Antique Red	2 Lines
SILVER	$300.00	4”x8” #51 Imperial Beige	2 Lines
Gold	$500.00	8”x8” #32 Antique Red	3 Lines
EMERALD	$1000.00	8”x8” Imperial Beige	3 Lines
DIAMOND	$1500.00	12”x12” Granite	4 Lines

Each line can have up to 17 characters including punctuation and spaces.
A third line is available for an additional $15.00. Some emblems can be engraved. Ask for a quote

ORDER FORM (Copy, print and mail) or
copy and paste in an Email to eljebel@eljebelshrine.org

El Jebel Plaza Order Form

_______ Bricks at the _______________ Level Engraved as Follows

Line #1 _______________________________________________________

Line #2 _______________________________________________________

Line #3 ______________________________________________________
(Gold & Emerald Level)

Line #4 _____________________________________________________
(Diamond Level)

Put Special Requests and instructions on another page

NAME ___________________________________PHONE _____________

ADDRESS ___________________________________________________

City _________________________ State ___________ Zip ___________

$_____ Enclosed OR ( )I will make __ Monthly Payments of $ ____

Please charge to my Visa MC (Circle one)

Card Number ______________________________Ex Date __________

Signature ___________________________________________________

Be advised that this order is not tax deductible

Mail to: El Jebel Plaza. C/O El Jebel Shrine,
4625 W. 50^th Avenue, Denver, CO 80212

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