EmailMe Form - Request for Brick

Request for Brick

Our Raleigh campus includes two special walkways for those who want to honor loved ones with an engraved brick. The Veterans Garden honors veterans from all military branches. Our Colonnade and Memory Garden near the Sanctuary includes a winding walkway featuring a fountain. Orders received September 16-March 15 will be installed in May; orders received by March 16-September 15 will be installed in November.

Donor's name(s) *
Prefix First Last Suffix
Donor's address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Donor's phone (best daytime number to call) *
### - ### - ####
Donor's email address *
Where do you want your brick? *
Veterans Garden brick sizes: choose one *
4" x 8" ($150)
8" x 8" ($300)
Colonnade brick sizes: choose one *
4" x 8" ($150)
8" x 8" ($300)
12" x 12" ($500)
Branch of service *
Optional graphics are available on 8" x 8" bricks for an additional $15 per graphic (you may choose up to 3)
American flag
butterfly
cherub
heart
medical symbol-Caduceus
musical symbol-treble clef
prayer hands
rose
sailboat
Optional graphics are available on 12" x 12" bricks for an additional $15 per graphic (you may choose up to 3)
American flag
butterfly
cherub
heart
medical symbol-Caduceus
musical symbol-treble clef
prayer hands
rose
sailboat
Veterans Garden brick: type your text here. You may have up to 3 lines of text total, with each line limited to 18 characters (including blank spaces, punctuation, letters, and numbers). LINE 1 required *
Veterans Garden brick: type your text here. LINE 2 optional
Veterans Garden brick: type your text here. LINE 3 optional
Colonnade brick: type your text here. You may have up to 3 lines of text total, with each line limited to 18 characters (including blank spaces, punctuation, letters, and numbers). LINE 1 required *
Colonnade brick: type your text here. LINE 2 optional
Colonnade brick: type your text here. LINE 3 optional
Veterans Garden brick: type your text here. You may have up to 4 lines of text total, with each line limited to 18 characters (including blank spaces, punctuation, letters, and numbers). LINE 1 required *
Veterans Garden brick: type your text here. LINE 2 optional
Veterans Garden brick: type your text here. LINE 3 optional
Veterans Garden brick: type your text here. LINE 4 optional
Colonnade brick: type your text here. You may have up to 4 lines of text total, with each line limited to 18 characters (including blank spaces, punctuation, letters, and numbers). LINE 1 required *
Colonnade brick: type your text here. LINE 2 optional
Colonnade brick: type your text here. LINE 3 optional
Colonnade brick: type your text here. LINE 4 optional
Colonnade brick: type your text here. You may have up to 6 lines of text total, with each line limited to 22 characters (including blank spaces, punctuation, letters, and numbers). LINE 1 required *
Colonnade brick: type your text here. LINE 2 optional
Colonnade brick: type your text here. LINE 3 optional
Colonnade brick: type your text here. LINE 4 optional
Colonnade brick: type your text here. LINE 5 optional
Colonnade brick: type your text here. LINE 6 optional
I would like to make this gift in honor/memory of someone special *
yes
no
Indicate name of special person. If you would like an acknowledgment card sent, indicate recipient's Name, Address, and Their Relationship to special person
Would you like to receive our quarterly e-newsletter? If "yes," we will use the email address you provided above (you may opt out at any time)
yes
no


Total	$0.00