Alumni Plaza Brick Order Form

Please complete the form below to order a brick to be placed in the Alumni Plaza using your credit or debit card. To pay by other methods, please use the printable brick order form to place your order.

All proceeds from your brick purchase will go to the Ozarks Annual Scholarship Fund.

 Brick Information
Please enter the name as you want it engraved on the brick.
Gift Type:
Alum's class year:  
Brick Amount: $
Additional Gift Amount: $
 Cardholder Information
* Firstname:
* Lastname:
* Address:
* City:
* State:
* Zip Code:
Email Address:
To receive an electronic confirmation for your gift, please supply your email address.
Phone Number:  -  - 
 Card Information
Accepted card types
* Credit Card Type:
Merchant Services