Memorial Brick Order Form

Please fill out the following information to purchase a personalized brick on our Memorial Pathway. 

Please mail or drop (at the Receiver of Taxes) a $100 check made payable to:
Town of Halfmoon, Veterans Memorial
2 Halfmoon Town Plaza
Halfmoon, NY 12065
 
If you would like print a hard copy of the application, please click here.
 
Please note, this order will not be complete until payment is received.
Contact Information
Brick Information

16 characters per line including spaces and punctuation

16 characters per line including spaces and punctuation

16 characters per line including spaces and punctuation (format example 1952-1959)

Please include information about his/her military service, family, education, and career. (250 word maximum)