Rt 58 Sign

Start Building Your Legacy Right Now!

You can become a part of our brick legacy by having your name, or the name of a loved one, engraved on a commemorative brick in the Garden Plaza. The brick may be engraved with a friend or family name, creating a lasting gift. You may also choose to honor or memorialize someone who has made a difference in your life, such as a patient, a caregiver, a parent, a spouse, a child, or a friend.

We invite you to participate in this ongoing historic opportunity by purchasing an 8" x 8" or 4" x 8" Garden brick, with proceeds benefiting PBMC Health. All bricks are laser-engraved for lasting clarity. You can fill out your brick inscription form with your payment below or if you wish you can download the form and either fax or mail it back with your payment.

If you don't wish to purchase a brick but would rather make a memorial donation, please click here.

Forms

8" x 8" Garden Brick Inscription Form - $250	Start
4" x 8" Garden Brick Inscription Form - $150	Start

Donation Information

For more information on any giving level, please call 631-548-6080

Amount:

8" x 8" Garden Brick

$ 250.00

4" x 8" Garden Brick

$ 150.00

Additional Information

Type of gift:

One-time gift (pledge or credit/debit card)

Recurring gift (credit/debit card)

Installments (credit/debit card)

Corporate:

This donation is on behalf of a company

Anonymous:

I prefer to make this donation anonymously

Comments:

How Did You Hear About Our Site:

Billing Information

Title:

First name:

Last name:

Country:

Address lines:

City:

State:

ZIP:

Phone:

Email:

Payment Information

Cardholder's Name:

Card Number:

Card Type:

Card Expiration:

Card Security Code:

Matching Gifts

My company will match my gift

Tribute Information

Type:

First name:

Last name:

Mail a letter on my behalf

To purchase a brick online fill out the inscription form by clicking on the Start button to the far right of the type of brick you are purchasing and then fill out your payment information.

For more information or to speak with someone in the PBMC Health Foundation Office, please call 631-.548-6080.