Custom Brick Order Form

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Please fill out this form to order a custom brick as part of the new entry plaza at the Harold G. Norton Athletic Complex. After filling out the form, you will be taken to the online payment processing service. Thank you for your generous contribution.

(Please note, you will need to fill out this form for each brick you wish to purchase. When you checkout on the payment page, please adjust the the quantity of bricks appropriately.)

*ASRSD reserves the right to reject any brick orders that fail to comply with School Committee policies.

First and Last Name *

Your Address (Street, City, State, Zip Code) *

Best Phone Number To Reach You *

Line 1 Text To Display (20 capital letters, numbers, apostrophes (‘), ampersands (&) and/or spaces ) *

Line 2 Text To Display (20 capital letters, numbers, apostrophes (‘), ampersands (&) and/or spaces )

Line 3 Text To Display (20 capital letters, numbers, apostrophes (‘), ampersands (&) and/or spaces )

Are You An ASRSD/AHS alum? Enter Your Graduation Year.

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