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
2A Halfmoon Town Plaza
Halfmoon, NY 12065
 
If you would like to 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)
Files must be less than 1.95 MB.
Allowed file types: gif jpg jpeg png.
Please include information about his/her military service, family, education, and career. (250 word maximum)