Islip Booster Club- Islip High School - (Islip, NY)

8x8 Prestige Square Brick Order

This form is for a 8x8 Prestige Brick:

• Price is $150
• Up to 6 lines of text
• Maximum of 14 letters/spaces per line (no symbols available)
• An additional identical brick for home is $50 ($200 total for both)

If paying by check, please complete the form and choose payment option "Checkout - Pay By Check" upon checkout. Mail a check payable to:

Islip Booster Club:
P.O. Box 467
Islip, NY 11751

**Cash or check payments must be received within two weeks or the brick order will be relinquished. All checks must be post marked by May 31,2024

Visa-Mastercard-Discovery credit cards are accepted.

* First and Last Name:

* Phone number with area code:

* E-Mail Address (for confirmation):

* Line 1 Message (max. 14 letters/spaces, no symbols):

Line 2 Message (max. 14 letters/spaces, no symbols):

Line 3 Message (max. 14 letters/spaces, no symbols):

Line 4 Message (max. 14 letters/spaces, no symbols):

Line 5 Message (max. 14 letters/spaces, no symbols):

Line 6 Message (max. 14 letters/spaces, no symbols):

***I have carefully reviewed my order and understand that no changes may be made after the order is processed. Any changes (i.e., text) will require an additional order payment. *

* indicates required fields