Rocky Hill School -> Alumni -> Order an Alumni Brick

BRICKWALK ORDER FORM

Name

First*

Last*

Class of

Contact Information (credit card billing address)

Street*

City*

State*

Zip*

Phone*

Email Address*

Number of bricks you would like to order @ $100 per brick?

(Please note: If you would like to order more than 3 bricks, please call

401-884-9070 x 132 to complete your order)

Number of Bricks

@ $100.00

Form Total: $0.00

Brick 1 Location:

I would like my brick to be placed in the:

Garden Classroom

Senior Brickwalk

Hopelands Brickwalk

Traditionally, bricks in the Senior Brickwalk are reserved for graduates of the current senior class. These bricks are ordered in May and installed prior to Commencement in June. Senior Brickwalk bricks are inscribed with the student's name and graduation year only: Example: NATHAN HALE / CLASS OF 20XX

If you would like additional inscription options, please consider purchasing a brick in either the Hopelands or Garden Brickwalks. Thank you.

Brick 1 - Inscription

Each brick inscription is limited to 3 lines; maximum of 14 characters per line.

Enter your brick inscription below, please use a "/" to indicate line break:

	Make my gift anonymous
	Notify the honoree

Brick 1 Honoree's Name and Address (if applicable):

Brick 2 Location:

I would like my brick to be placed in the:

Garden Classroom

Senior Brickwalk

Hopelands Brickwalk

Brick 2 Inscription

Each brick inscription is limited to 3 lines; maximum of 14 characters per line.

Enter your brick inscription below, please use a "/" to indicate line break:

	Make my gift anonymous
	Notify the honoree

Brick 2 Honoree's Name and Address (if applicable):

Brick 3 Location:

I would like my brick to be placed in the:

Garden Classroom

Senior Brickwalk

Hopelands Brickwalk

Brick 3 Inscription

Each brick inscription is limited to 3 lines; maximum of 14 characters per line.

Enter your brick inscription below, please use a "/" to indicate line break:

	Make my gift anonymous
	Notify the honoree

Brick 3 Honoree's Name and Address (if applicable):

Credit Card Information

Name on Card*

Card Type*

Credit Card Number*

Expiration Month*

Expiration Year*

CCV*

Thank you for purchasing an inscribed brick(s) from the Alumni Association. If you have any questions, please feel free to contact Director of Alumni Relations Liz Cochran at 401-884-9070 ext. 132 or ecochran@rockyhill.org.