1998 Volume 121 No 1–4 - Phi Delta Theta Scroll Archive

BECOME A PERMANENT PART OF PHI DELTA THETA HISTORY.
For a tax-deductible gift ofjnst $150 (U.S. dollars) you, and those you honor, can forever be a part
of the special courtyard commemorating 150 years of Phi Delta Theta brotherhood.
\
Yes, I want to be a part of Phi Delta Theta's Sesquicentennial Courtyard!
#i- NAME OF INDIVIDUAL ORDERING BRICK PHONE NO.
STREET ADDRESS
.»*,**!!*•
CITY STATE/PROVINCE ZIP/POSTAL CODE
IF YOU ARE A PHI DELT: CHAPTER BOND NO. GRADUATION YEAR
You may make a gift on behalf of yourself, or in honor or memory of someone. Each beautifully
inscribed brick will be personalized to your specifications; three lines—with up to 18 characters
per line, including spaces—are available.
&15U-
Engraving will include name, chapter abbreviation, Bond number and graduation year. For nonmembers,
engraving may show name and connection with OA©; please provide suggestion.
For each gift paid in flill, a commemorative rendering of the brick will be sent to you recognizing
your gift. If you would like this commemorative rendering matted and framed for hanging,
please add $30 (not tax-deductible) to your gift, for a total of $180. (The original $150
gift remains tax-deductible.)
'-'3^.-
Please check one. This gift is: • for myself -or-
Indicate how you would like brick inscribed:
in • honor • memory of someone
(Please supply name and address
of individual to be notified.)
FIRST LINE
SECOND LINE
THIRD LINE
• \
..,•
\ Photocopy
i this page,
I or send the
I origiii.ll with
i your check.
Examples:
JOHN WOLFE
LINDLEY
OH A #4 1850
JOHN AND JANE
MARTIN
PARENTS
GEORGE BANTA JR.
IN B #352 1914
JANE B. DOE
DELTA GAMMA
Gift Payment
Total number of gifts/bricks ordered:
$150 each (U.S. dollars):
Please mat/frame brick rendering(s):
$30 each (U.S. dollars):
Vor deferred payment options, please contact the Phi Delta Theta Educational Foundation.
Tax-deductible
Not tax-deductible
TOTAL
Phi Delta Theta Educational Foundation 2 \vcinic ().\f()i-d, Ohio 4.S(),S6 Id Sl.i 52.V6966
• My check made payable to
Phi Delta Theta Educational
Foundation is enclosed.
Please charge my gift to:
• VISA • MC • AmEx
EXP. DATE
ACCOUNT NO.
SIGNATURE