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8x8 brick order form

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Sample Bricks:

Order Form for 8" x 8" Inscribed Brick
The maximum number of form submissions has been reached. This form is currently not available.
- The cost for an 8" x 8" brick is $250 each.
  
  To order a 8" 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 Maximum 30 characters Please enter valid data.
- Brick inscription: Maximum 5 lines of text with 14 characters per line including spaces.
- Cost of 8" x 8" Brick250.0
- Number of Bricks- Size 8 x 8 REQUIRED Please fill out this field.
  
  Brick 1
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 2
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 3
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 4
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 5
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 6
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 7
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 8
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 9
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 10
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 11
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 12
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 13
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 14
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 15
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 16
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 17
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 18
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 19
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth Line Maximum 14 characters Please enter valid data.
  
  Brick 20
  
  Brick Inscription:  Maximum 5 lines of text with 14 characters per line including spaces.
  
  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.
  
  Fourth Line Maximum 14 characters Please enter valid data.
  
  Fifth 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.

8x8 brick order form

Sample Bricks:

Order Form for 8" x 8" Inscribed Brick