Take a Seat
TAKE A SEAT!
PLAQUE ORDER FORM
Please fill out this form and return it to: Alumni & Friends; 100 Amsterdam Ave., room 853, New York, NY 10023. Questions? Call 212-595-1301.
Please print the message/name to be engraved on the plaque clearly. Consider including messages such as: In Honor of, In Memory of, Congratulations, or simply the name of your business or alumni and their graduate year. Text can be up to 2 lines, 30 letters per line.
NAME_____________________________________________________________________________________________
ADDRESS___________________________________________________________________________________________
CITY/STATE/ZIP_____________________________________________________________________________________
PHONE____________________________________________________________________________________________
EMAIL_____________________________________________________________________________________________
SCHOOL/GRADUATION YEAR (if applicable)_______________________________________________________________
PAYMENT METHOD
CHECK ENCLOSED (payable to Alumni and Friends)
CREDIT CARDS: Please return this form along with the following information
Please charge $______ to my Visa MC AMEX Discover (CIRCLE ONE)
__________________________________________________________________________________________
Credit Card Number Expiration Date Security Code
___________________________________________________________________________________________
Signature
THANK YOU FOR YOUR GIFT!
*For additional plaques, please provide the same information requested for each plaque on a separate piece of paper