Brick Order Form

Brick Order Form

An engraved brick is a perfect way to honor or remember someone special, whether it is a graduate, a loved one, or a faculty member that goes above and beyond. Part of the money from brick purchases goes to support the PCC Foundation and our institution’s programs.
Name
Address
City/State/Zip
Daytime Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Number of Bricks Ordered
Total Cost (number of bricks x $100)
Preferred Walkway
Inscription Line 1 (ALL CAPS, max 17 characters)
Inscription Line 2 (ALL CAPS, max 17 characters)
Inscription Line 3 (ALL CAPS, max 17 characters)
If your brick is in honor or in memory of a friend or family member and you would like us to notify that person, please fill out the information below.
Acknowledgment Type
Acknowledgment Recipient Name
Acknowledgment Recipient Address
Acknowledgment Recipient City/State/Zip
Proceeds benefit the PCC Foundation’s scholarship program and other activities in support of PCC students, faculty, and staff. All contributions are tax deductible.

For questions, contact: Tammy Duncan at tammy.duncan@piedmontcc.edu
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Brick
$100.00 Quantity

Total

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Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

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Proceeds benefit the PCC Foundation’s scholarship program and other activities in support of PCC students, faculty, and staff. All contributions are tax deductible.