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| provost / center for women / news, events & brownbags |
The Legacy Courtyard
Print out this form and mail it to:
Catharine S. Eberly Center for Women
University of Toledo
2801 W. Bancroft St. M/S 502
Toledo, OH 43606
or fax to 419.530.8575
* Each engraved brick is a minimum of $250 or a minimum of
$1,000
(surrounding the keystone)
100% tax deductible. One order form per brick
please.
Inscription: $250 bricks - 2 lines, 30 characters max;
$1,000 bricks - 3
lines, 40 characters max
Inscription:______________________________________________________________________
Your Name: ______________________________________________________________________
Mailing Address: _________________________________________________________________
City/Town: __________________________________________ Postal Code: ________________
Phone #: ___________________________E-mail: ______________________________________
Amount donated: _____________________
Method of Payment: Check VISA MasterCard Am Express
Card Holder’s Name _______________________________________________________________
Credit Card Account # ____________________________________________________________
Exp Date: ______________
Signature: _______________________________________________________________________
* Make checks payable to UT Foundation/Legacy Courtyard.
* Send us the story of your brick, along with your check, to be published
on our website.
For information, call 419.530.8570