Brick Order

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.
After you submit the form, you will be able to pay by PayPal or credit card*.
If the brick is in honor of someone, please indicate his or her name in the box above. This is for our records. The name doesn't necessarily appear on the brick, unless requested on the inscription below.

Brick Inscription

Example of Memorial Brick

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

Special characters count as two characters. Please use the following code to specify a special character.
%1 =         %2 =
%3 =         %4 =

$ 0.00