EmailMe Form - Waynesburg University Brick Fundraiser

Choose Your Brick

*

4” x 8” bricks can be personalized with up to 3 lines of text , 20 characters per line without clip art or 16 characters with clip art.

Click to display or hide clip art.

Please add clip art

Please include a Mini Replica Brick for my home or office (Add $25)

Line 1:

Line 2:

Line 3:

Brick placement *

Choose Your Clip Art

All messages are subject to review. In the unlikely event your message is not considered appropriate, you will be contacted to either revise the message, or have your donation refunded. Please, no emojis, websites, email addresses, phone numbers or political messages.

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Phone *

### - ### - ####

Email *

What is your relationship to Waynesburg University?

PLEASE ONLY CLICK THE "SUBMIT" BUTTON ONCE.
AFTER CLICKING "SUBMIT" YOU WILL BE TAKEN TO A SEPARATE SCREEN TO PAY BY CREDIT CARD.