MedWish International · MedWish Building Brick ($500)

Amount

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$500

Donation Schedule

Name

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First Name

Last Name

Email

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Contact Information

Is this gift in honor or memory of someone?

In Honor

In Memory

Tribute Name

First Name

Last Name

Who would you like to have notified of this gift?

First Name

Last Name

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Email to Notify

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Brick Inscription

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With your donation of $500, one brick will be inscribed with your name or the name of your honoree. Please insert the text that you want inscribed on the brick. There is an option of having up to 3 rows on the brick, each row has the maximum of 20 characters each. Please note that each letter, numeral, punctuation or space counts as a character. Tax deductible amount: $450.

Check here if you'd like to opt out of email updates from MedWish

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In an environmental effort to reduce paper usage, MedWish donors have the option to receive thank you letters/donation receipts via email or hard copy. Please select which manner you would prefer to receive your donation acknowledgement.

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