Bricks Order Form
ALUMNI/MEMORIAL BRICKS
Please place your order by the three examples below only. We suggest that women use their maiden names on the bricks (this is how your classmates remember you) PLEASE PRINT.
EXAMPLES
Alumni
Jane Wilson
Class of 1955
In Memory Of
John Jones
Class of 1940
Teacher / Vice-Principal / Principal / Counselor
John Smith
1960 to 1980
First line __________________________________________________
Name ____________________________________________________
Year ____________________________________________________
Please print and send this application along with a check or money order for $35.00 to Wilby High School Alumni Association, PO Box 4503, Waterbury, CT 06704
Construction of the walkway will begin in the fall. Bricks are ivory with emerald green fill.
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