St. Simons Rotary Club
Veteran’s Walk

Application Form Brick Locator Contact Us Home Page

Order Form for Bricks
(Print this form, fill out and mail as indicated below)
(Print the form as a .PDF document)

Amount Enclosed $ ___________________  ($75 per brick )
Given by  ________________________________________    Phone  _____________________________
Address  ________________________________________________________________________________

Information pertaining to the person being honored or remembered: The first line contains the name of the veteran. Other optional information that may be included on the first line or on the remaining two lines are: rank; branch of service; dates of service; war or conflict (for example WW II, Vietnam); awards; or special recognition such as POW, MIA or KIA.
Refer to our Military Titles & Abbreviations Page for help with abbreviations.
Punctuation and blank spaces count as characters.     EXAMPLE:

LINE1 L T . J O H N O . D O E , J R .
LINE2 U . S . A R M Y , 1 9 4 3 - 1 9 4 6
LINE3 W W I I - B R O N Z E S T A R

Complete the blocks exactly as you want it to read on the brick beginning on the left side. It is not necessary to center the lettering. That will be done when the bricks are engraved.

LINE1
LINE2
LINE3

THANK YOU FOR YOUR SUPPORT OF VETERAN’S WALK 
Due to volume of engraved bricks in place, we can no longer accommodate special placement requests.  Submit this form along with your payment to:
Phillip Carlyle, Chairman - Veteran’s Walk,
Rotary Club of St. Simons Island,  207 Edwards Plaza Rd
St. Simons Island, GA 31522.   For more information call: (912) 638-5909

Thank you for your order. We appreciate your interest in Veteran’s Walk. Orders for bricks will be sent to the supplier every 3 to 6 months. We purchase our engraved bricks in larger volumes to maintain a reasonable price. Do not think we have forgotten you. Six months is our longest schedule.