Building a Legacy
Brick by Brick

Employee Order Form

To place your order online, please provide the information requested below or: click here to download a printable order form to order by mail or fax.

Step 1: Order

Number of Bricks:

Engraved Brick
x $100 each

Replica Brick
x $25 each

(Replica Brick(s) ships in 6-8 weeks to shipping address specified in Step 3)

Inscription Guidelines:

  • 16 characters per line maximum, including spaces
    and punctuation marks. You may use any symbol
    on a standard computer keyboard.
  • Inscriptions will communicate non-commercial
    messages only. Company names can be used. Phone
    numbers, e-mail and web addresses, slogans, sales
    pitches, and logos cannot be used. We cannot guarantee
    location of your brick.
  • St. Luke’s reserves the right to approve all text prior
    to inscription.
  • You will receive a confirmation letter in 2-3 weeks
    to review the imprint as it will appear on your brick.

My Brick Should Be Inscribed as Follows:

Line 1:

Line 2:

Line 3:

Proceed to Step 2: Verify Amount/ Inscription


top
  • Ways to Give
  • Boise Medical Center
navigation