POMEROY VETERAN’S MEMORIAL PARK ENGRAVED BRICK ORDER FORM 

You or family members are invited to be a permanent part of Pomeroy Veteran's history by
purchasing engraved bricks for use in the Veteran's Memorial Park. The brick may commemorate
the memory of a loved family veteran or may represent a family member currently serving in the
military. These bricks will be placed in the center or along the sidewalk of a memorial walkway in the
Pomeroy Veteran's Memorial Park. Benches in the park allow visitors a place to relax and view the
names of those memorialized.

Bricks are available as: 4 X 8 charcoal blend for $50.00. Each brick can hold three lines of 14 - 16
characters each. These make great memorial gifts. If a veteran were killed in the line of duty,
a white cross will be placed on the brick. Directions for ordering a Veteran's Memorial Brick:

  1. The person memorialized must have been a veteran from the Pomeroy area.
  2. This form is for one brick only. Please use a separate form for each person memorialized.
  3. Print exactly as you wish to have it appear on the stone. Each punctuation mark counts as one space.
  4. Information will be centered on the stone for you.
  5. If this veteran was killed in the line of duty, please indicate that here: _________________
  6. The city reserves the right to reject inscriptions it deems inappropriate or to rearrange the
information you give us if we feel it would work better on the brick in another way.
  7. Stones will be placed in a random design and place.
                               
                               
                               
 
Samples:
Don W. Hohensee
Air Force
1/5/1925-4/10/1980
John Doe WWII
Navy So. Pacific
1927-1995
Jane Doe, Army
Inf. 122 Germany
6/1942 – 6/19
 
I would like to order:
____ One charcoal blend 4” X 8” brick. Enclosed is $50.00. A separate form for each brick ordered, please.
Make checks payable to “Pomeroy Veteran’s Memorial Park".
  Name: _________________________________ Mailing Address: ______________________________
City: ___________________________________ State: _________________ Zip: _________________
Phone: _________________________________ Email: ______________________________________
Mail completed form and check to: Cindy Loots or Deb Gray
  Cinday Loots
P.O. Box 38
Pomeroy, IA 50575
Phone: (712) 468-2529
Deb Gray
P.O. Box 7
Pomeroy, IA 50575