HIGHLANDER
Legacy Plaza
Brick Paver Order Form
Yes! I want to make my mark on McLennans campus and purchase a brick paver for the
Highlander Legacy Plaza located behind the Dennis F. Michaelis Academic Center!
Name:
Address:
City, State, Zip Code:
Phone:
E-mail:
*Payment Options:
Check, payable to the MCC Foundation
Monthly withholding (MCC Employees only - Please also complete the Foundation Giving Form.)
Visa MasterCard Discover American Express
Name on Card: Card Billing Address:
Card Number:
Expiration Date: 3-Digit Security Code:
Signature: Date:
Paver size:
Paver
4” x 8”
3 Line Inscription
$200
*Inscription on brick paver will be completed upon payment in full. Installation may take several months.
Paver Inscription: Complete a separate form for each paver.
Paver max 12 letters/line.
Line 1 :
Line 2 :
Line 3 :
Return to: e MCC Foundation | 1400 College Drive, Waco, Texas 76708 | F: 254-299-8484 | P: 254-299-8604
click to sign
signature
click to edit