Legacy Wall
Leave a legacy which will improve the education of the next generation of CHS Dragons and make your mark all at the same time! All tiles will be prominently placed between the activities entrance and the high school gym at CHS for generations of Dragons to see and appreciate! If you'd prefer to do a paper form, please download from the bottom of this page and return to Farmers State Bank in Downtown Cameron.
Name
*
First Name
Last Name
Suffix
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Legacy Message
Please tell us line by line what you would like on your tile. Note your message must only have 16 characters (including spaces) per line. A standard tile may have up to 3 lines. Up to 5 lines are available for an additional donation.
Line 1
*
16 characters max including spaces
Line 2
16 characters max including spaces
Line 3
16 characters max including spaces
Line 4 (Please note this will incur an additional $10 charge and font will be smaller to accommodate extra lines)
Line 5 (Please note this will incur an additional $10 charge and font will be smaller to accommodate extra lines)
Legacy Tile--All tiles include 3 lines of text at no additional charge
*
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( X )
6" x 6" Legacy Tile
$50.00
$
50.00
4 Lines of Text
$10.00
$
10.00
5 Lines of Text
$10.00
$
10.00
Total
$0.00
$
0.00
PLEASE TYPE YOUR COMPLETE INITIALS TO CONFIRM YOU HAVE PAID THE ACCURATE PRICING FOR YOUR ORDER. (3 LlINES-$50, 4 LINES-$60, 5 LINES-$70). ANY ORDER WITH INCORRECT PRICING WILL NOT BE PROCESSED UNTIL PAID IN FULL!
*
PLEASE PLACE INITIALS TO CONFIRM THE TEXT YOU HAVE ENTERED FOR YOUR BLOCK IS SPELLED AND SPACED CORRECTLY. THE FOUNDATION CANNOT BE HELD RESPONSIBLE FOR ANY TYPOS ON THIS FORM.
*
PLEASE INITIAL TO CONFIRM YOU UNDERSTAND BLOCKS WILL ONLY BE PLACED ONCE AN ACADEMIC YEAR--BEFORE GRADUATION.
*
Is there anything else you would like the foundation to know?
Save
You may print for your completed form for your files
If you'd rather complete your form on paper, please click the link to download on the right.
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