T.C. WILLIAMS HIGH SCHOOL
1965-2007

BRICKS
ORDER FORM
(WHILE SUPPLIES LAST)

Name___________________________________________________________________

Mailing Address __________________________________________________________

City ____________________________________________________________________

State_____________________________________ Zip _________________________

Telephone_____________________ E-Mail ___________________________________

Bricks will be inscribed and will have certificate of authentication.

Quantity Bricks ___________ @ $100.00 each = $ _________________

(Includes shipping/ handling lower 48 states. Email RL1572@hotmail.com for additional destination surcharge to other areas.) **$60.00 Tax-deduction.

Also Available
Titan Pride T-Shirts (50/50 cotton-polyester)
White Shirt with red or blue lettering TITAN PRIDE over heart, and on right shoulder

Quantity at Clearance $10.00 each (while supplies last)

XL _______________________2XL _______________________

3XL _______________________4XL _______________________

Shirt Total $___________

Grand Total $_________________________________

Mail to:Titan Fund, Atten: Rufus Littlejohn, POB 23371, Alexandria, Virginia 22304

Make Checks Payable To: ’71 Original Titans

Memo: Titan Bricks/Shirts