Veterans Memorial
Brick Order Form:

Please etch my name and/or message into
Troy history with a personalized brick paver
at the Veterans Memorial Park.

The bricks are approximately 4x8 inches and the name must be within 3 lines or 12 spaces.
There is a tax-deductible minimum donation of $60 per brick, and all orders are final.

Purchaser's Name:______________________________________________________

Address:______________________________________________________________

City:_____________________________ State:__________ Zip:________________

Daytime Phone Number:______________________

Evening Phone Number:_______________________

Please print the individual or family name in the grid below. Leave a blank space between names. The $60 donation includes 26 characters, including spaces.

                       

                       

                       

___ Check if person spent time in the service. A star will be added to their brick.

___ Check box if you want a gift certificate sent to you.

Please fill out this Brick Order form and mail with a check made payable to:

Troy Veterans’ Memorial Fund
c/o Community Foundation of Troy
1120 E. Long Lake Road, Suite 205
Troy, Michigan 48098

Upon receipt of your check and order form, you will be sent a confirmation notice.

 

EXAMPLE:

I
N
H
O
N
O
R
O
F

O
U
R
F
A
T
H
E
R

S
G
T
J
O
H
N
D
O
E

For additional information please contact the
Community Foundation of Troy at 248-740-7600