MEMORIAL PAVER APPLICATION

MARINE CORPS LEAGUE DETACHMENT 246

46 Ontario Avenue

STATEN ISLAND, New York 10301

Telephone Number 718-447-2360     Fax Number 718-447-2376

Agreement made on_________________     Between____________________________________

and the Marine Corps Detachment 246 for an engraved brick. To be placed on our property around our monument.

Pavers (brick) will be engraved in lots of 20. Each Paver will cost $100.00 each.

Any Veteran or Veterans family are invited to purchase a brick.

Detachment upon review has the right to refuse any application and any money received will be returned.

All money received will be applied to our Detachment Building Fund for future expansion and up grades.

All Pavers become the Property of  of the Marine Corps League Staten Island Detachment 246.

Make Checks Payable To:

Marine Corps League

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Name Of  Person Purchasing Pavers

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ADDRESS___________________________________________

CITY_____________________  STATE________________  ZIP______________

Telephone Number_____________________     Size 8 3/4 X 5 3/4

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