Memorial Bricks
With your donation of $500, a personalized, engraved brick
will be embedded in the memorial walkway at Levine &
Dickson Hospice House-Huntersville or in the garden path at
Levine & Dickson Hospice House at Southminster.
Ceremonies to dedicate memorial bricks are held at the
hospice houses; each spring and fall in Huntersville, and
each fall at Southminster.
Levine & Dickson Hospice House-Huntersville
1900 Vanstory Drive, Huntersville, NC 28078
Sunday, April 2, 2017 at 2pm
Please return order forms and
payment for spring ceremony
by February 3, 2017.
Dedication ceremonies at Levine & Dickson Hospice House
at Southminster occur once each year. The next ceremony will be fall 2017.
Your Name:
Address:
City, State & Zip:
Phone Number:
Email:
(Please include for notification purposes)
I would like to order ________ bricks (4” x 8”) @ $500 each = $__________
Please select a location: Levine & Dickson Hospice House-Huntersville (Spring 2017)
If hand-writing, please print clearly and exactly as you would like your engraving to appear.
All letters, punctuation and spaces count as one character. You do not have to use all three lines.
We respectfully ask that you limit special characters to one per brick
(additional characters will incur an extra cost).
3 lines maximum
1 character per space
20 characters per line
Click here to submit!
Please make checks payable to: Levine & Dickson Hospice House
Attn: Pam Janowicz Gray • 1420 East Seventh Street • Charlotte, NC 28204
Questions? Contact Pam Janowicz Gray at 704.335.4324 or by email: [email protected]