To Order Call: (602) 258-4822 or Fax: (602) 258-4825

Make Checks Payable to

INTER TRIBAL COUNCIL OF ARIZONA, INC.
2214 North Central Avenue, Suite 100
Phoenix, Arizona 85004

Include the following information:

Name:____________________________________

Address:__________________________________

City/State: ___________________ ZIP: _________

Telephone number:_(_______)____________
All names and addresses are for ordering and tax information only.

Name or Message to be engraved on the brick
Print very clearly, no more than 15 characters per line, including spaces and punctuation.

The Inter Tribal Council of Arizona, Inc. reserves the right to refuse inapproprite words, names or messages.