MPHS Alumni & Veteran Walkway Brick Order Form


Name: ______________________________________________________

Maiden Name:_________________________________

Street:_______________________________________________________________

Town/State/Zip:________________________________________________________

Phone:_____________________

Fax:_______________________

E-mail:__________________________________________________

Class of:___________

______ YES, I am interested in becoming a member of the MPHS Alumni Association!
______ NO, I would not like to be a member of the MPHS Alumni Association.

GUIDELINES:
1.) You will have three (3) lines of type for inscription purposes
2.) Each line may be up to thirteen (13) characters long, including spaces and punctuation.
3.) Each brick will contain one (1) name only, not multiple names.
4.) If you have multiple names, contact us about placing them in groups.
5.) NO advertisements, please!

LINE 1 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

LINE 2 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

LINE 3 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

Please include a check to: MPHS Walkway in the amount of $40.00. Checks should be mailed to: MPHS Alumni Association, Inc., c/o John A. Bandstra, 126 Paterson Avenue, Midland Park, NJ 07432

If you need more information, you may call Vinny and Kathy (Culleeny) Piscitello at 201-445-7626 or John Bandstra at 201-444-2515. You may also leave e-mail to John.


Go back to:
1.) Welcome Page
2.) Walkway Page
3.) Alumni Newsletter
4.) The "Panther Hunt" (missing alumni)
5.) The MPHS Alumni Mentoring Program
6.) Leave E-mail
7.) Reunion info
8.) Membership Application
9.) Alumni Comments