Wall of Service

Wall of Service Order Form

If you purchase your Brick before May 11, 2012, it will be included in the June installation. Purchase by September 28, 2012, and the brick will be included in the November installation. A Brick purchased before November 9, 2012, will be included in the December.

Step 1 of 2 (Information)

Purchaser’s Information
  1. (required)
  2. (required)
  3. (required)
  4. (required)
  5. (required)
  6. (required)
  7. (valid email required)
  8. (required)
Wall of Service Information
  2. (required)
  3. (required)
  4. Guidelines: Maximum of 32 characters including spaces and punctuation for the rank and name. - Maximum of 32 characters for the Service/Regiment/Ship. No symbols, titles or dates are permitted.
Recipient(s)’ Information
  1. (required)
  8. (required)
  9. With your approval, your personal message, if provided above, will also be released for the sole use of the Pier 21 Society. It may be shared in-house, online and electronically. This gives Pier 21 Society permission to share your message but not your address. Please let us know if you have any questions.
 

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