Order Form
View Paver and Leaf Placement

Please fill out the below form to order your 4"x8", 8"x8" or 12"x12" Paver Brick or Bronze Memorial Leaf.

Note: This form is setup for ordering 1-3 leaves, or 1 of the pavers only. If multiple pavers are needed, or if a combination is needed, they must be ordered by a separate form. If questions or problems, please contact us at (512) 401-5228.

Veterans Name:
Click here to see how the Bronze Maple Leaf would look Like
Click here to see how the 4x8 Paver Brick with 2 lines of text would look Like
Click here to see how the 4x8 Paver Brick with 3 lines of text would look Like
Click here to see how the 8x8 Paver Brick would look Like
Click here to see how the 12x12 Paver Brick would look Like
Branch of Military Service:


Bronze Memorial Leaf

Donation: $50.00 each or 3 for $125
Choose # of Leafs
(Limited to 30 characters per line, including punctuation marks, letters and spaces, 2 line limit)

Leaf 1

Line 1:

Line 2:




4x8 Paver Brick
Click here to see how the 4x8 Paver Brick with 2 lines of text would look
Click here to see how the 4x8 Paver Brick with 3 lines of text would look

Inscription:
(Limited to 16 characters per line, including punctuation marks, letters and spaces, 2 line Minimum ($35) or 3 line Maximum ($50))

Line 1:

Line 2:


8x8 Paver Brick

 6 Lines - $75 Donation
Inscription:

(Limited to 16 characters per line, including punctuation marks, letters and spaces, 6 line Maximum)

Line 1:

Line 2:
Line 3:
Line 4:
Line 5:
Line 6:


12x12 Paver Brick
Click here to see how the 12x12 Paver Brick would look

 9 Lines - $100 Donation
Inscription:

(Limited to 22 characters per line, including punctuation marks, letters and spaces, 9 line Maximum)

Line 1:

Line 2:
Line 3:
Line 4:
Line 5:
Line 6:
Line 7:
Line 8:
Line 9:


PURCHASED BY
Name:
Phone Number:
Email Address:
Street:
City:
State:
Zip:

Donations to the Cedar Park Veterans Memorial through the CERT/Veterans Memorial Project are to a 501(c)3 organization (Tax ID# 20-5680541) and are tax deductible as allowed by law.

Produced by the Cedar Park Veterans Memorial
Citizen Advisory Group and CERT (501c3)
Tax ID#20-5680541


Questions? Contact Us at
(512) 401-5228
cpvetmemorial@gmail.com