Bricks Order Form
ALUMNI/MEMORIAL BRICKS
Please place your order by the three examples below only. 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
(only 21 characters per line - 18 recommended
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
Bricks are ivory with emerald green fill.
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