Wisconsin Humane Society

Gift & Payment Information

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Personalized Paving Brick Order Form

Bordering the walkways of the main entrances at our Milwaukee, Ozaukee, Racine, Green Bay, and Door County Campuses are personalized bricks featuring tributes to well-loved people and animals. The bricks provide a great opportunity to honor or memorialize a family member, friend, or animal companion while supporting the lifesaving work of WHS.

Inscriptions vary from 3-4 lines with 16-21 characters per line, depending on location and inventory. Once you complete this payment form, a staff member from your chosen campus will be in touch within 2 business days to collect your inscription and complete your order.

Field Is Required Select brick type:

$250.00

4"x8" brick

$500.00

8"x8" brick

Billing Information

First Name:

Last Name:

Street 1:

Street 2:

City:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Yes, I would like to receive communication from this organization.

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Which campus would you like your brick placed at?

What would you like your brick to say? (3 lines, 16 characters per line including spaces)

Payment Information

Payment Method:

Credit Card

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?