Brick Order – Friends of Hyder Family Hospice House

A Memorial Brick costs $50. All project profits help to support Friends of Hyder Family Hospice House.
Please fill out and submit the form below.
You may submit payment by credit card or PayPal below or by sending a check payable to FHFHH to:

Friends of Hyder Family Hospice House
285 County Farm Rd.
Dover, NH 03820

Each brick may contain up to three lines. Up to 14 characters, including spaces and punctuation, are permitted on each line.

Number of bricks you wish to order *

Name of Honoree, if applicable.

If the brick is in honor of someone, please indicate his or her name in the box above.

Name *

First

Last

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Inscription on Brick:

Each brick may contain up to 3 lines. Up to 14 characters on each line.

Additional information or inquiry

To submit payment by PayPal or credit card, please specify the number of bricks you would like and click button below.

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