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The Bricks Campaign Form for Students

This form was last changed on November 26, 2012

Start a Penn State Harrisburg tradition

Create a permanent, lasting memory of your time at Penn State Harrisburg by purchasing a personalized brick to be placed on the Ziegler Commons adjacent to the Olmsted Building. Add to its appeal by having your name, a loved one’s name, or another message engraved on a brick in the Commons.

For the price of your $100 general deposit, you receive permanent recognition as a contributor to Penn State Harrisburg. Three lines of 14 characters each will fit on a brick–you can include the Nittany Lion image as one of the lines.

To authorize the use of your general deposit for the Senior Class Gift, please submit the following form.

Student Information


(e.g. 90000001)

(e.g. cjw29)






(including area code)

I would like my gift to fund


If you seleted "Other," please specifiy what you would like your gift to fund.

I wish to pledge


If you selected a "Portion of my General Deposit," or "Cash Gift," please specify the amount of your gift.

 

**The balance of your deposit ($100) is required for the personalized brick. The $100 General Deposit was paid when you enrolled at Penn State. This money was used while you were a student to cover any emergency expenses. Upon graduation, any fees that may prohibit your ability to receive your diploma will be removed from this fund. What remains may be used to pledge to the senior class gift.

I understand that if I choose this option and do not have $100 remaining in my general deposit, I am responsible for the balance to purchase the brick. Those graduates with a balance will receive a letter asking them to pay the balance or the deposit will be donated to the 2011 Senior Class Gift Fund.

Personalize your brick

I would like to personalize my brick with the following:

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Enter the characters shown in the image.