Commemorative Brick Paver Order Form

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Commemorative Brick Paver Order Form THE COMMEMORATIVE BRICK PAVER PROGRAM

honorarium for someone special.

Support the Northern Kentucky University SOCCER Program and enjoy permanent recognition of your commitment to help NKU blaze a path.

Your brick paver will be installed in front of the NKU Soccer Stadium, allowing your special message to be remembered for a lifetime.

Personalize your brick paver by inscribing your name, a significant date, a meaningful quote, a memorial or

Brick pavers are installed once per year, usually in late May.

Please print your message exactly as you would like it to appear on your brick paver. Each paver can accommodate a maximum of 3 lines of text with 14 characters (including spaces and punctuation) on each line. Letters will be in all caps.

NAME__________________________________________________________________________________________ ADDRESS_______________________________________________________________________________________ ______________________________________________ ________________________________________ PHONE_____________________________________ E-MAIL__________________________________________

METHOD OF PAYMENT: Cost is $100 per paver

PLEASE MAIL THE COMPLETED FORM TO: Go Norse Fund c/o NKU Athletics BB&T Arena 500 Nunn Drive Highland Heights, KY 41099

FOR MORE INFORMATION, PLEASE CONTACT Gina Huiet Go Norse Fund

(859) 572-7894 [email protected]

gonorsefund.Com

PLEASE BILL MY CREDIT CARD:  Visa ____  MasterCard_ ACCOUNT #________________________________________ EXP.____________ SECURITY CODE_______ PRINTED CARDHOLDER NAME______________________________________________________________ SIGNATURE_______________________________________________________________________________ MY CHECK IS ENCLOSED (payable to the NKU Foundation) I am not interested in the Commemorative Brick Paver Program at this time. However, please accept my contribution to the Go Norse Fund in the amount of $_______________.

This publication was prepared by Northern Kentucky University. NKU is an affirmative action/equal opportunity institution. 49187