Your Support Paves the Way!

Legacy Brick Order Form

Your Support Paves the Way! Honor a loved one, celebrate an achievement, or create a lasting tribute with an engraved brick in the heart of our campus library. Your personalized brick will become a permanent part of UP's story, inspiring future generations. Purchase an engraved brick and leave your mark on the future, today!
Name of Contact Person:

First NameLast Name
Organization Name (if applicable):
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
BRICK INFORMATION

Cost of Brick: $300.00

Brick Size: Three lines, 14 spaces per line (including blank spaces)

Example

Line 1: Linda Smith (11 total spaces)

Line 2: Class of 2020 (13 total spaces)

Line 3: Go Argos! (9 total spaces)

You are not requred to use all three lines.
Font Case (Please choose one):
Line 1 (14 spaces including blank spaces):
Line 2 (14 spaces including blank spaces):
Line 3 (14 spaces including blank spaces):
Signature: By signing below, I have proofread the above brick engraving form and attest that the above information is correct and is to be engraved as written above.
PAYMENT OPTIONS

Option 1:

Please click HERE to make your payment online.

Option 2:

Make your check payable to: University of Providence Legacy Brick

Mail to:

Advancement Department

1301 20th Street South

Great Falls, MT 59405

Thank you for your support!

For questions, please visit Roy Lanham, Chief Advancement Officer at roy.lanham@uprovidence.edu | 406.791.5230.
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Legacy Brick Order Form

BRICK INFORMATION

PAYMENT OPTIONS

Option 1:

Option 2: