Coleman Middle School PTSA COBRA COURT PAVER ORDER FORM

Coleman Middle School PTSA COBRA COURT PAVER ORDER FORM Deadline for Fall Installation October 14, 2016 COLEMAN MIDDLE SCHOOL HAS A GREAT HISTORY IN TAMPA In honor of our 50th Anniversary, Coleman enhanced the school front entrance with a beautiful pavered area for use by all students, staff and visitors. Show your support and celebrate your tenure at Coleman by purchasing a paver to last for years to come. Your generosity will provide the PTSA the necessary funds to enhance the educational experience of all of our students. Dedicate your paver to your family, child, alumni member, student club/activity group or favorite teacher.

Small Paver = $75.00

Large = $125.00

Up to 3 lines per brick - 14 characters per line including spaces

Up to 5 lines per brick - 14 characters per line including spaces

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Name of Person Placing Order: _______________________________________________________________ Date ______________ Email: ____________________________________ Phone #: ____________________

THANK YOU! PLEASE MAKE CHECK PAYABLE TO COLEMAN PTSA  Cash Received  Check Received

Cash Amount $__________ Rec By _________ Check Amount $___________ Check # _________