BUY A BROUGHTON BRICK        
WILEY WARREN MEMORIAL BRICK      
                 
                 
                 
COST:   $100 PER BRICK        
                 
MAKE CHECKS PAYABLE TO:  BROUGHTON CAPS CLUB    
(WILEY WARREN FUND ON MEMO LINE)        
                 
                 
BRICK ENGRAVING          
                 
                 
NAME  ______________________________________________________
                 
GRADUATING CLASS __________________________________________
                 
                 
PLEASE RETURN THIS FORM ALONG WITH YOUR PAYMENT TO:    
                 
CHRIS NEWTON              
BROUGHTON BASEBALL MEMORIAL          
723 SAINT MARY’S STREET            
RALEIGH, NC 27605