Neosho R-5 School District
Charitable Foundation

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      Neosho High School & Alumni Fence Project

      The Deadline has been extended.
      But hurry, you don't want to miss out on this opportunity.
       
      Picture
      MEMORIAL FENCE PROJECT
      LASER ENGRAVED BRICK ORDER FORM

      Alumni Name:  ___________________________________________________________________________________

      Phone Number: _____________________________ Mailing Address: ________________________________________

      City: _______________________ State: _______________ Zip Code: ______________

      Email: ______________________________________________________

      Brick Information: $40.00 each
      Line 1:  (Maximum 21 Characters)  __   __   __   __   __   __   __   __   __   __   __   __   __   __   __   __   __   __   __   __   __
      Line 2: (Optional-Year/Max. 4 Characters)  __   __   __   __

      Sample:
      Willie Wildcat
                           Class of 1977

      Return this form and payment to:
      Mrs. Tonya Patterson
      C/O Neosho Charitable Foundation
      418 Fairground Rd.
      Neosho, Missouri 64850

      Make Checks Payable to:
      Neosho Charitable Foundation

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