Wall of Service Order Form

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.

Purchaser’s Information
Wall of Service Information

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

With your approval, your personal message, if provided above, will also be released for the sole use of the Canadian Museum of Immigration at Pier 21. It may be shared in-house, online and electronically. This gives Pier 21 Society permission to share you