2007 Brick Paver Order Form

Saline County Veteran's Memorial

"Walk of Honor"

To order a paver for the Saline County "Walk of Honor", enter the name of any honorably discharged Veteran, or a Veteran who is presently serving in the United States Military in the spaces below.

Veteran's Name (Please Print Clearly)

First Name:  ______________________________________

Middle Initial:  ________

Last Name:  ______________________________________

Branch of Service:  ________________________________ (Only One)

Order's Information

Your Name:  ______________________________________

Your Address:  ____________________________________

City, State, Zip:  ___________________________________

Phone where we can reach you:  _____________________________

1.

There will be three lines on the paver, the first line will be the first name and middle initial, the second line will be the last name and the third line will be the branch of service (only one branch of service per paver).

2.

Fill out this order form and mail a check payable to the Saline County Veteran's Memorial for $35.00 to the Saline County Courthouse, 200 N. Main Street, Benton, AR  72015

3.

We will place the order for the pavers on December 31, 2007, and it usually takes about three months to receive the pavers.

4.

Hopefully this order will be placed in the "Walk of Honor" in April, 2008.