Donation level I: $100.00
Primary Surface Pavers - 8" x 8" clay brick with laser engraving. (approximately 1,650 available)

Donation level II: $250.00
Wings of the Eagle - 12" x 12" clay brick with laser engraving. (approximately 350 available)

Donation level III: SOLD OUT

Pleas fill out the order form and send with your tax deductible payment made payable to:
Portage County Veterans Memorial
c/o Portage Community Bank
1311 E. Main Street
Ravenna, OH 44266
*  *  *  *  *  *  *

__________________________________
Your Name

__________________________________
Address
__________________________________

__________________________________
Phone

Brick Inscription
(please select one of the following choices)

A.  Name and Rank of Veteran:
____________________________
____________________________

    Branch of Service
____________________________

    Years of Service (if known):
____________________________

B. In Memory of:

 Name and Rank of Veteran:
____________________________
____________________________

    Branch of Service
____________________________

    Years of Service (if known):
____________________________

C.  In Support of All Portage County Veterans
____________________________
     (Your Name. Or Organization's Name)

Thank you for your generosity and for helping us honor our veterans.

Portage County Board of Commissioners
Chuck Keiper
Christopher Smeiles
Maureen T. Frederick