Prefill Info

Source Code

Logged In?

True

Tile Purchase Type

Texas ExesCowboys

Buy Your

Commemorative Plaque, Tile, or Brick

Choose your brick below

8" x 4" Brick $4508" x 8" Tile $75016" x 8" Tile $1,000 Hexagon

Hexagon

17" Hexagonal Tile $5,000 Bronze Plate

Bronze Plate

12" x 16" Bronze Plaque $15,000 Bronze Plate

Bronze Plate

12" x 16" DAA Bronze Plaque $15000

If desired you can leave your inscription blank and provide it later

Leave my inscription blank and contact me later to provide it

Inscription

Line #1

You may enter up to 18 characters

Line #2

You may enter up to 18 characters

Inscription

Line 1

You may enter up to 21 characters

Line 2

You may enter up to 21 characters

Line 3

You may enter up to 21 characters

Line 4

You may enter up to 21 characters

This is a gift

Email an acknowledgement to the tile recipient

YesNo

Gift Recipient Contact Information

First name

Last name

Email

Street

City

State

Postal code

Country

UT EID

If known

Class year

Purchaser Information

First name

Last name

Street address

City

State

Postal code

Country

Email

Email type

PersonalWorkAlternate

Lead Web Source

Phone

Phone type

HomeMobileWork

UT EID

If known

Class year

Is billing information same as purchaser?

YesNo

Billing Information

First Name

Last Name

Street address

City

State

Postal code

Amount

Tiles Total

Would you like to donate to further the work of the Texas Exes?

$

Yes, I’ll donate an additional 2.5% to cover any related expenses so my full gift supports Texas Exes programs

$

Total:

$

Amount to charge:

$

We appreciate your support of the Texas Exes! For payments greater than $16,000 please contact us at 800-594-3935, or mail a check to Texas Exes, P.O. Box 12368, Austin TX, 78711.

CREDIT CARD:

Card Type

Credit card

CVV code

Expiration month

Expiration year

Chargent Order info

Double-checking you're not spam

What is 9+8?

reCAPTCHA helps prevent automated form spam.

The submit button will be disabled until you complete the CAPTCHA.

Contact Information

To learn more about how the Texas Exes keeps your information secure, click here.