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.  

Customize Line 2 (Required)

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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 payment will be