Pewter Ornament Order Form

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ALUMNI SQUARE FUND

FIRST EDITION PEWTER ORNAMENT

BELL TOWER ORNAMENT ORDER FORM
Please help support Leetonia Alumni Association's "BELL TOWER PEWTER ORNAMENT" sale. ALL PROFITS FROM THE ORNAMENT SALE WILL GO TOWARD THE ALUMNI SQUARE PROJECT. Any funds remaining following completion will be placed in the Scholarship Fund.

*REQUIRED
Please provide the following contact information:

*First Name *Last Name

Middle Initial Maiden Name

*Street Address Address (cont.)

*City *State/Province

*Zip/Postal Code Country

* Phone E-mail

Organization URL

FIRST EDITION PEWTER ORNAMENT

50th Anniversary of the Leetonia High School Memorial Bell Tower, 1952-2002

QTY PEWTER ORNAMENT EACH TOTAL

To be mailed $23.95

To be picked up at Holloway Insurance, Main Street, Columbiana $20.00

TOTAL
ENCLOSED:

Check # Money Order

THANK YOU FOR YOUR SUPPORT

Office Use Only

PRINT BELL TOWER ORNAMENT ORDER FORM and SEND TO:

Donations can be sent to:

Leetonia Alumni Association
Attn: "ALUMNI SQUARE PROJECT"
PO Box 71
Leetonia, OH 44431

*REQUIRED	Please provide the following contact information:
*First Name		*Last Name
Middle Initial		Maiden Name
*Street Address		Address (cont.)
*City		*State/Province
*Zip/Postal Code		Country
* Phone		E-mail
Organization		URL

QTY	PEWTER ORNAMENT	EACH	TOTAL
	To be mailed	$23.95
	To be picked up at Holloway Insurance, Main Street, Columbiana	$20.00
	TOTAL	ENCLOSED: