UAM Weevil Walk

UAM Weevil Walk

Online Brick Order Form
Please complete the fields below EXACTLY as you would like your brick to appear. Leave spaces between names, and before and after "&". Each space counts as a character. Orders received together will be placed together.

Suggested wording on bricks:

Name (first line) and class year (second line)

Optional:"In Memory of" or "In Honor of ""In Memory of" or "In Honor of "

The UAM Foundation Fund reserves the right to approve all inscriptions.

VISA, MasterCard, and American Express accepted. Your sponsorship is tax deductible.

Questions?
Please call the UAM Office of Advancement at 870-460-1028 or toll-free at 1-800-467-8148.
* Indicated fields required for submission.

$100.00 Brick 4" X 8"
Red brick with black laser lettering
Two lines maximum
14 characters per line (must be upper case)
No commas
Please enter your personalized text in the fields below: 2 lines
Name of person sponsoring brick.*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Confidentiality Statement:
The University of Arkansas at Monticello is very concerned with the security of financial information and transactions on the Internet. The information submitted on this form is protected by a secure server. Information submitted on this form is for the use of UAM only and will not be shared with any outside individuals.
Questions?
Please call or write the Office of Advancement at:
P.O. Box 3520
Monticello, AR 71656
870-460-1028
1-800-467-8148

My Products

BrickUAM Weevil Brick

$100.00

Total

$0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty: