Drew Central High School
Alumni Courtyard
Engraved Brick Order Form

(Alumni and Friends of Drew Central are encouraged to support our project.)

Brick pavers will be standard 4"x8" pavers. Engraving is limited to a maximum of 18 characters per line, including spaces and punctuation marks, and a maximum of 3 lines. Use the space below to indicate how you want YOUR brick to be engraved. Print one character per box.

After you have filled in the form above with your information, print this page on your printer and mail this form, along with your check for $30.00, made payable to Drew Central High School, to:

Drew Central High School
Engraved Brick Project
440 Hwy 83 South
Monticello, AR 71655

Your Name:_______________________________________________________

Address:__________________________________________________________

City:____________________________________ State:________ Zip:_________

Daytime Phone:(_____ )_______________Evening Phone:(_____)_____________

Email Address:______________________________________________________