Help Our Garden Grow!

Credit Card Donation Form

You may purchase a brick in honor of or in memory of a woman who has been/was doagnosed with a gynecologic cancer.  Gynecologic cancers include malignancies of the ovary, endometrium, uterus, cervix, vulva, and vagina. To order one or more bricks, fill in the proposed inscription(s) below exactly as you want the brick to appear. Fill in multiple forms for multiple bricks.  If you do not know a woman affected by a gynecologic cancer, please consider donating a brick in honor of our organization. 


 JANE LILY           JANE LILY               JANE LILY            JANE LILY                LILIES OF THE VALLEY
                                  BY                       1925 - 2001                                                          BY                                 
                            JOHN LILY
                                                                                    JOHN SMITH

Type inscription below.  Text limited to 4 lines of text, 21 characters per line (letters, numbers, spaces all count as characters).
All inscriptions subject to the approval of the Lilies of the Valley Board of Directors.

The individual whose name appears on the brick was diagnosed with

Your Name (required)

Your Street Address (required)

Your City (required)

Your State (required)

Your Zip Code (required)

Your Phone (required)

Your Email (required)


Please enter the 4-digit code you see above. This proves to the computer that you are a person and not a robot, preventing us from getting a lot of spam. :)


 Press "send" to complete Step 1!

Proceed below to complete your order!


To complete payment for your order, you will visit the JustGIve site to pay by credit card.  This site is a secure site.  A $5 convenience fee applies.  If you prefer not to pay the convenience fee, you may pay by check using our mail order form.

Your inscription was received in Step 1.  When you go to the JustGive Site, place the amount of your donation in the “I Would Like to Donate” box.  This amount should equal $100 per brick plus $5 for the transaction.  (1 brick = $105.00.) You do not have to specify a dedication nor designation.

Add the donation to your basket and follow direction to submit credit card information.  Donations will show up on your credit card statement to reflect a donation to JustGive.  You will receive a receipt for your tax deduction.

**Your order is not complete until we receive the order form and have verified the payment by credit card.  Please remember to add the $5 convenience fee when entering your total donation.

Click here to complete your donation and pay by credit card.

 Brick orders may be placed any time but bricks are installed annually in September.
Orders placed after June of any year, will be installed the following September.

Thank you for your support of

The Lilies of the Valley Garden of Life and Remembrance.