BRICK ORDER FORM

I am making a tax-deductible donation to the Commemorative Brick Program benefiting the women and children of Shepherd’s Gate in the amount designated below to have a personalized brick placed in the Honor Garden.

 

Contact Information

* If this Brick dedication is on behalf of an organization, please list your organization name below:

Organization Name
Country*
Email*
Confirm Email*
Phone*

 

 

SUGGESTED MESSAGES

  

Below is a list of suggested messages to be included on bricks. Patrons may also include names, bible verses and/or dates.

 

  • IN HONOR OF
  • WITH THANKS TO
  • HAPPY GRADUATION
  • I LOVE YOU (MOM, DAD, GRANDPARENTS, ETC)
  • TO RECOGNIZE
  • IN MEMORY OF
  • WORLD'S GREATEST
  • CONGRATULATIONS
  • BEST WISHES
  • IN OUR HEARTS
  • WELCOME TO THE WORLD
  • COMMEMORATING
  • LEAVING A LEGACY
  • HEAVENLY TREASURE

 

PLEASE ENGRAVE THE FOLLOWING ON MY BRICK

 

Maximum of 3 lines (which will be centered on the brick),

21 characters per line including spaces 

All letters capitalized

Engrave on Line 1:
Engrave on Line 2:
Engrave on Line 3:

Gift Information

Donation Amount*
  • $500

If you would like to purchase multiple bricks, please do a separate transaction for each brick.

Payment Information

Amount*
$
After you complete this form, select Submit to enter your payment details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.
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