Anna Jaques Hospital - Beth Israel Deaconess Medical Center

Build a Path to the Future at AJH

With a gift of $500 or $1,000, you can purchase a brick to honor loved ones, friends, special physicians/nurses, or simply demonstrate your support by with a phrase or well wishes.

The gift of an inscribed brick leaves your mark for decades to come on the well-traveled paths around our campus.

** A $500 gift purchases a 4-inch by 8-inch brick (3 lines; 22 characters per line)
** A $1,000 gift purchases an 8-inch by 8-inch brick (6 lines; 22 characters per line)

* = Required fields

* All fields are required unless indicated as optional.

Gift Amount

Field Is Required Select Gift Amount:

$500.00

$500 4x8 Legacy Brick

$1,000.00

$1,000 8x8 Legacy Brick

Gift Information

Brick Line 1

Brick Line 2

Brick Line 3

Brick Line 4 (for $1,000 donations and 8x8 brick gifts)

Brick Line 5 (for $1,000 donations and 8x8 brick gifts)

Brick Line 6 (for $1,000 donations and 8x8 brick gifts)

Field Is Required Gift Designation:

Where it's needed most

Select gift designation

Other

I would like to make this donation anonymously (optional)

I am making this gift in honor or memory of a person important to me (optional)

Honor Gift Type:

Honoree First Name:

Honoree Last Name:

Notification Recipient Name:

Notification Recipient Street 1:

Notification Recipient Street 2:

Notification Recipient City:

Notification Recipient State/Province:

Notification Recipient ZIP/Postal Code:

Message Body:

My employer will match this gift (optional)

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Your Information

Credit:

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Contact:

Title

First Name

Last Name

Phone

Street Address

City

State/Province

ZIP

Country

Questions about giving? Contact us: helpwithgiving@ajh.org

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