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4x8 brick order form

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Sample Bricks:

Order Form for 4" x 8" Inscribed Brick
The maximum number of form submissions has been reached. This form is currently not available.
- The cost for a 4" x 8" paver is $125 each.
  
  To order a 4" x 8" inscribed brick, please complete the order form below. To order multiple bricks with different inscriptions, please note the number of bricks you want to purchase. A fillable inscription form will appear for each brick ordered.
  
  If you have any questions or would like help with your inscription, contact us and we will get back with you.
  
  Please note that bricks ordered at this time will be placed in the next phase of construction as the Walk of Honor is extended.
- Purchaser's Information:
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address: REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email: REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Are you a member of a Veterans or Civic Organization? If so, please note which one such as the American Legion, Kiwanis, etc.
- Name or Number of Designated Post or Council Please enter valid data.
- Cost of 4 x 8 Brick125.0
- Number of Bricks REQUIRED
  If you would like to order more than one brick with different inscriptions, please fill out a form for each brick.
  Please fill out this field.
  
  Brick 1
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 2
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 3
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 4
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 5
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 6
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 7
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 8
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 9
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
  
  Brick 10
  
  Brick inscription: Maximum 3 lines of text with 14 characters per line.
  
  First Line REQUIRED Maximum 14 characters Please fill out this field. Please enter valid data.
  
  Second Line Maximum 14 characters Please enter valid data.
  
  Third Line Maximum 14 characters Please enter valid data.
- I would like to make an additional donation to the Memorial: $ Please enter a positive decimal.
Total:

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The Michigan WWII Legacy Memorial

Honoring sacrifice. Celebrating freedom. educating generations.

4x8 brick order form

Sample Bricks:

Order Form for 4" x 8" Inscribed Brick