Memory Brick Order Form
Use this form to purchase Memory Bricks for current/former students or faculty for Pasadena Memorial High School. All payments are made through the Online Credit Card System. Bricks will not be ordered until payment is received.
Contact Information
Name
Please enter the name of the person we should contact if we have any questions about your brick order.
Your answer
Phone
Please enter the best number to contact you with any questions.
Your answer
Email
Please enter an email address to contact you with any questions.
Your answer
Example Brick
Brick Information
Type of Brick
Wall Bricks are located by the Auditorium. In Memory Of bricks are for students or faculty that have passed away and will be placed at the Remembrance Tree in the courtyard.
1st Line
20 characters per line -- please type information exactly as it should appear--use N/A if you would like to leave blank
Your answer
2nd Line
20 characters per line -- please type information exactly as it should appear--use N/A if you would like to leave blank
Your answer
3rd Line
20 characters per line -- please type information exactly as it should appear--use N/A if you would like to leave blank
Your answer
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