Central Piedmont Brick Donation

* Indicates required field

Fill out the form below to order 1 brick for $125. Each 4x8-inch brick has space for 3 lines with 18 characters each. The text will engraved in all caps and will be centered on the brick. Carefully enter your desired text below. 

Brick Line 1 *
Brick Line 2
Brick Line 3

*Please review your text lines for accuracy. 

Choose Campus Location for Your Brick (Please note earliest placement dates.) *

Honor/Memorial Giving

My gift is    
Whom should we notify

Please enter your Contact Information

First Name *
Last Name *
Email *
Phone *
Address *
Country *
City *
State/Province *
Zip/Postal *

Please enter your Billing Information

We accept the following cards
Name on Card *
Card Number *
Card Expiration Date *
Card Verification Value (CVV) *
Same as Contact Information
Billing Address *
Country *
City *
State/Province *
Zip/Postal *

*Please ensure that your text for the brick engraving is accurate. Once you hit the submit button, you cannot re-enter the information. 

Would you like to cover the transaction processing fee?
Yes   No
Your Donation:
Processing Fee:
Total Payment: