Printable mail-in form - University of Wisconsin-Madison - geology wisc 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your name in the designated field. Ensure that it is spelled correctly as this will be inscribed on the brick.
3. If applicable, enter your degree(s) and year(s) in the respective fields. This information helps personalize your brick further.
4. Select a designation if you are not an alumnus/alumna. Choose from Faculty, Staff, Friend, or leave it blank if not applicable.
5. Choose a specialty area from the provided options such as Economic, Geochemistry, or others listed. If none apply, select 'No specialty area'.
6. Indicate whether you wish to remain anonymous if you have donated a brick for someone else by selecting 'yes' or 'no'.
7. Fill out your contact information including name, address, city/state/ZIP code, and phone/email/fax for any follow-up communication.
8. Once completed, print the form and mail it along with your check for $200 to the specified address.

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