Birthday Marquee
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Email *
Purchasers Name: *
Phone: *
Student to be recognized: *
Birth Date: *
MM
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DD
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YYYY
Select the Start Date (your ad will run for 3 days) *
MM
/
DD
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YYYY
Payment of $25 must be paid on the YHS Webstore and received SEVEN DAYS PRIOR to the requested date in order to ensure timely posting on the marquee. 

After payment please return to this form, add payment confirmation number and select SUBMIT.
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