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Commemorative Bricks Order Form

Inscribed with messages that are lasting memories, joyful tributes and fond farewells, the bricks visibly honor loved ones and serve as a gentle reminder of how often they are thought about and how much they are loved. Each brick is an enduring tribute to those who have touched our lives. To order your special heartfelt brick which will be placed within our pathway along the Olivia's House Healing Garden, please complete the form below.



Contact Information
First Name
Last Name
Address
 
City
State
Zip
Phone ( ) - ext.
Email
   
Relationship to memorialized loved one:
   
Name(s) and addresses of others who might want to attend the Healing Garden
placement ceremony:
   
Commemorative Brick Information
Each brick is a standard (4X8 inches) and can be inscribed with three lines of copy with a maximum of 14 characters per line. Numbers, spaces, dashes, and punctuation marks count as one character. All text will be in capital letters and centered on the brick.
   
Line 1
Line 2
Line 3
   
Donation Amount $ A minimum donation of $75 per brick is requested.
Additional Donation $
   
Comments
   
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