Honor and Remember a Loved One with a Personalized Brick

Cancer is a hard path to walk. It takes courage. And above all it takes hope.

By purchasing a personalized engraved brick to honor or memorialize an important person in your life, you create a lasting mark in the world that mirrors the permanent impact of that person on your heart.

You also provide a wheelchair, hospital bed, transportation assistance, medical supplies, emotional support, and other very needed services to someone who is walking their cancer path right now.

Your brick will be prominently placed outside at Cancer Services of Northeast Indiana’s headquarters in Fort Wayne.

Order your Brick

Order your personalized brick using this form.

Bricks are installed from April through November during three scheduled periods each year. Because installation is completed by volunteers, it may take three to five months for placement. We’ll notify you once your brick is installed.

If you have questions or would like to submit your order over the phone, please contact Cancer Services of Northeast Indiana at:

Jessica Misserbiev
Director of Donor Impact
Direct Line: (260) 255-3750

Cancer Services of Northeast Indiana
EIN: 35-0965609

Memorial Brick(Required)
My brick is(Required)
Must be 16 characters or less, including spaces

Donor Data

Donor Names(Required)
Address(Required)

Next of Kin

If you would like next of kin to be notified of your brick purchase, provide their name and address.
Name
Address

Payment

Credit Card(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date