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Alice Campbell Alumni Center — Illinois Paver Order Form

THIS IS A SECURE SITE.

USE THIS ELECTRONIC FORM FOR:
online credit card payments for engraving of Alumni Center pavers, including gift or memorial engravings.

OR USE THE PRINTABLE (PDF) FORM INSTEAD FOR:
payments with a check, payroll deductions, matching gifts, requests for placement near another specific paver or use of Greek letters.
Download PDF paver form (176 KB): PDF paver form
Download Adobe Reader for viewing PDFs: Get Adobe Acrobat at www.adobe.com/products/acrobat/readstep.html.

OTHER OPTIONS:
For payment options not listed on this form or the PDF, to find out more about the Alumni Center and for other inquiries, contact the Alumni Association office at 217/333-1471 or 800/355-2586 or alumni@uillinois.edu.

IMPORTANT NOTE:

  • All engraving entries are subject to the approval of the University of Illinois Alumni Association Board of Directors.
  • This form accepts MasterCard, Visa, Discover and American Express.
Planned paver layout.
Representation of the three paver types: light gray, charcoal and red.

These are only representative illustrations of pavers. Colors are approximate and sizes are not exactly to scale.


Required fields are in red.

First Name
Middle Name
Last Name
Degree

 Year
 E-mail Address
Street Address
City

 State or Province

 Zip Code
Country

 Home Phone

 Work Phone
 
IF THIS IS A JOINT ORDER, PLEASE INCLUDE SECOND PERSON'S NAME:

First Name
Middle Name
Last Name

Relationship to purchaser (optional)

QUANTITY:

Light Gray Paver @ $600
12" x 12" light gray tile, engraving of up to 3 lines
3/4" text height, maximum 16 characters/spaces per line.
Number that are gifts or memorials.

Charcoal Paver @ $600
12" x 12" charcoal gray tile, engraving of up to 3 lines
3/4" text height, maximum 16 characters/spaces per line.
Number that are gifts or memorials.

Red Paver @ $1,200
24" x 24" red tile, engraving of up to 4 lines
3/4" text height, maximum 30 characters/spaces per line.
Number that are gifts or memorials.

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Alumni Service Center
800/355-2586
alumni@uillinois.edu