Brick Paver for Veteran’s Memorial
Order Form
Click in the boxes below and fill with your message (one character per box),
then print and mail or deliver (with $25 cash, check or money order payment) to:
City of Troy Cemetery Office
101 Riverside Drive
Troy, Ohio 45373
Up to three lines of text, with 14 characters maximum per line.
Spaces are considered characters
All capital letters or numerals ONLY
NO periods, commas, quotation marks, parentheses, or other
punctuation (dashes are acceptable)
Design elements are not available
Drawing approvals are not available
Three lines of fourteen characters
Please start from the left when filling in the boxes.
The actual engraving will be centered as shown in the examples above.
Name of Purchaser ___________________________________________
Street ______________________________________________________
City, State, Zip _______________________________________________
Phone (_____)_______________ E-mail __________________________
JIM ROBINSON
USAF
1980 - 1964
JACK WILLIAMS
7
TH
DIV ARMY
KOREA 1953-55
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