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LaGrange Veterans Memorial Pavers

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LaGrange Veterans Memorial Pavers

A 6"x 12" & 12" x 12" Granite Paver may be purchased for $60.00 & 100.00 respectively, to commemorate any veteran. The pavers will be placed in the vicinity of the monument.

VETERAN INFORMATION

Please fill out the following information on the veteran you are submitting. If you would like to purchase more than one paver please fill out a separate form for each veteran.

Veteran (please print)____________________________________________________
Years served___________________________________________________________
War served in__________________________________________________________

PAVER SIZE (please check one) _____ 6"x 12" $60.00
_____ 12"x 12" $100.00
_____ 12"x 12" w/emblem $175.00

6"x 6" 3 lines of inscription with limit of 17 characters per line. (Emblems not available on this size)

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

12"x 12" Either 3 lines of inscription with limit of 17 characters per line and emblem or 4 lines of inscription

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

Suggested first line:
In Memory Of
In Honor Of
Presented By

Emblem: ___ Army ___ Air Force ___ Marine ___ Navy

Purchaser Information

( PLEASE PRINT )
Name:____________________________________________________________________
Address: __________________________________________________________________
City/State/ Zip:_____________________________________________________________
Telephone:________________________________________________________________

Please make check payable to: LaGrange Veterans Memorial

Mail to:
LaGrange Veterans Memorial
P.O. Box 76
LaGrange, Maine 04453

For more information contact : Roger or Marlene Stanley
207-943-2564 or E-mail: stanleyroger@hotmail.com