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  • Wall of Service Order Form
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• Wadih M. Fares Wall of Tribute
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• Pier 21 Foundation

Wall of Service Order Form

If you purchase your Brick before May 7, 2010, it will be included in the June installation. Purchase by September 24, 2010, and the brick will be included in the November installation. A Brick purchased before October 29, 2010, will be included in the December installation.

Step 1 of 2 (Information)

Purchaser’s Information

1. Purchaser's Name(required)
2. Street(required)
3. City(required)
4. Province(required)
5. Postal Code(required)
6. Phone Number(required)
7. Email(valid email required)
8. Relationship to Recipient(s)(required)

Wall of Service Information

1. Person's Rank (if applicable)
2. Person's Name(required)
3. Service(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.
5. Gift Card is required Select One Yes (allow at least 4 weeks for delivery) No
6. Occasion
7. Personal Message and From Whom
8. Mail Card Select One To me Directly to recipient

Recipient(s)’ Information

1. Recipient(s)' Name(required)
2. Street
3. City
4. Province
5. Postal Code
6. Phone Number
7. Email Address
8. Connection to Pier 21 / Other Gateway Select One Veteran War Bride Other (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.
10. Approval Select One Yes, Pier 21 can use my message. No, please do not use my personal message.

 

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