There's a permanent place for you on campus.  Join the many others who have already purchased an engraved brick paver for themselves or for someone they know.

At only $250 each, proceeds help maintain the beauty of the Triplett Alumni Center: your home on the Ole Miss campus.

Bricks make great gifts, serving as a timeless way to honor someone you care for or love.  To reserve your space on the Ole Miss campus, simply complete the form on the back.
     For more information, please call the Alumni Office at (662)
915-7375.









 
Print
Yes, I want to help pave a path for the future of
       Ole Miss.
Name:_______________________________________________
Address:______________________________________________
City:___________________________State:_____Zip:_________
Phone:______________________Class Year:_______________
SSN:__________________________________________________
Email:________________________________________________

Please print name as it is to appear on the brick.  Each brick will have up to three lines of embossing, with up to 14 characters per line, including spaces and punctuation.  If you would like to purchase more than one brick, please place inscriptions on a separate sheet and attach it to this form, or additional forms may be obtained by calling (662) 915-7375.

Line 1:  __ __ __ __ __ __ __ __ __ __ __ __ __ __

Line 2:  __ __ __ __ __ __ __ __ __ __ __ __ __ __

Line 3:  __ __ __ __ __ __ __ __ __ __ __ __ __ __
Enclosed is my check for ___ bricks @ $250 each.
You may charge my Visa MastercardAmExpress
Card #____________________________Exp. Date ____/_____
Signature:____________________________________________

I pledge $___________ for the purchase of  ____ brick(s) to assist with the perpetual maintenance of the Triplett Alumni Center.
Payments will be made as follows:
___ Monthly (Bank Draft) ___Quarterly  ____Semi-Annually
Other (Please Describe)_________________________________
Company Name:_______________________________________
I wish my payments begin on: ____________________(date)
Name:_________________________________________________
Gift will be matched by:_________________________________
Company Name:________________________________________
Signature:______________________________________________

Make checks payable to:
The University of Mississippi Foundation

Mail to:
172 Triplett Alumni Center
P. O. Box 1848
University, MS 38677-1848

___ I do not wish my name to be publicized in connection with this gift