Panther Pride Paver Order Form
The Derby Education Foundation is selling granite pavers to be placed at the Derby High School entrance. This ongoing fundraiser will support grants for pre-K through 12th grade teachers and scholarships to students. Make a lasting tribute to education in Derby! Paver price is $150 for graduates, alumni and friends of education or $125 for Veterans (Veteran pavers will have a star (*) engraved on them).
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Your Name *
Your Mailing Address *
Your Phone Number *
Your E-mail Address *
Is this paver recipient a veteran? *
Is this paver a memorial for the recipient? *
Paver Recipient Name (A special letter will be sent to the recipient) *
Recipient Mailing Address (Please put N/A if this is a memorial paver) *
Recipient Email Address (Please put N/A if this is a memorial paver) *
Paver Inscription
Up to 3 lines of 12 characters per line including spaces can be engraved on each paver. Wording is subject to approval by the Derby Education Foundation. Football = FB, Soccer = SC, Basketball = BB, Volleyball = VB, Band = Band, Tennis = T, Baseball = Base, Swimming = SW, Wrestling = WR, Track = TK, Golf = Golf, Cross Country = CC, Cheerleader = Cheer, JROTC = JROTC, National Honor Society = NHS, Student Council = STUCO, Pantherettes = Dance, etc… (See website for example pictures)
Inscription Line 1 (limit 12 characters including spaces) *
Inscription Line 2 (limit 12 characters including spaces)
Inscription Line 3 (limit 12 characters including spaces)
Other Comments or Instructions
Payment for Pavers
Payment for your paver order can be by check payable to the Derby Education Foundation or submitted electronically through the Derby Education Foundation website.  Checks can be mailed to: Derby Education Foundation, 1550 E. Walnut Grove Road, Derby, KS. 67037.  Paver will not be ordered until correct payment has been received by the Derby Education Foundation.  Questions??: Contact us at derbyeducationfoundation.org.
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