Memorial Bricks 

Paving our way to a playground 

Making a donation and sponsoring a brick in memory of a loved one will help develop the new Community Build Playground at Centennial Park.  

The 4" X 8" memorial back are available for a minimum donation of $125 each. The customized, memorial bricks will be part of the walkway leading to the future playground at Centennial Park.  Memorial bricks will creating a lasting legacy. 

To sponsor a memorial brick please fill out the digital form below

or

download and print Memorial Brick Form with a check to 

Mid-Nebraska Community Foundation 

PO Box 1312 

North Platte, NE 69101 

or deliver your donation to Mid-Nebraska Community Foundation office at 121 N. Dewey St Suite 112.

 

 

 

BRICK INFORMATION

Brick Request Made By (Required)

Email (Required)

Phone Number (Required)

Amount (Required)

Memorial bricks are available for a minimum donation of $125 each

20 characters pre line, 3 line maximum.  The first line will say "IN MEMORY OF", line 2 and 3 can be customized.  This includes letters, numbers, places and punctuation. Please complete one form for each brick request.  Brick lettering will be in all caps.  

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Customize Line 2 (Required)

Customize Line 3

BILLING INFORMATION

Country

Address Line 1

City

State

Postal Code

Credit Card Information

Cardholder Name (Required)

Credit Card # (Required)

Visa MasterCard American Express Discover

Expiration Date (Required)

Security Code (Required)

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged