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garden of peace donation
Garden of Peace

The John K. Berry, M.D. Garden of Peace at The Women’s Hospital will provide a place for families and hospital employees to be surrounded by nature. Help us pave the way to this tranquil garden by purchasing a brick to celebrate a birth, a special occasion, or to memorialize someone you have lost.

* indicates a required field.

  Type of Brick *:
4 x 8 Brick: $100 (3 lines, 16 characters per line.)
8 x 8 Brick: $200 (6 lines, 16 characters per line.)
  Brick Information *:
  First Name *:
  Last Name *:
  Street *:
  City *:
State *:
Zip *:
 
  Phone *:
 
  Email *:
 
  Amount *:
  Name as it appears on card *:
  Credit type *:
  Card Number *:
  V-Code*
  Card Expiration Date*

NOTE:  This  form is a secured transaction.

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