Donation Form

Buy a Brick
Amount:	Brick $250.00 $     *
Recipient Information
Frequency:	Weekly Monthly Quarterly Annually Every 4 weeks On:   Sunday Monday Tuesday Wednesday Thursday Friday Saturday Starting:    Ending:   Ending:
Brick Inscription (Names only)*:		*
Class of:		*
Send Note to Brick Recipient:	Yes No
Your Message for Recipient:
Recipient's Address (Email):
Brick Placement Requests (if any)**:

*One name per brick (no nicknames allowed). If longer than 16 characters, name may continue on a second line. 

**All bricks will be placed in the Walkway at Maddock Alumni Center.

We are grateful for your support of Brown University through the Brick Walkway program. Please be advised that brick purchases are non-refundable. If you believe there has been an error processing your brick order, please contact our staff at brickwalkway@brown.edu.