Paver Application
Applicant Information
Your Name:
Address:
City:
State:                                      Zip:
Phone Number:
Email Address (Optional):
Veteran information
Name of Veteran
Branch of Service:
Campaign:
Veteran Eligbiltiy Dates (check one)
World War I   -  April 6 1917 to November 11 1918 [  ]
World War II  -  December 7 1941 to December 31 1946 [  ]
Korean War  -  June 25 1950 to January 31 1955 [  ]
Vietnam War  -  December 22 1961 to May 7 1975 [  ]
Lebanon and Grenada  -  August 24 1982 to July 31 1984 [  ]
Panama  -  December 20 1989 to January 31 1990 [  ]
Persian Gulf  -  August 2 1990 to Cessation of hostilities as determined by the U.S. Government [  ]   No Military Campaign But Did Serve Active Duty During Peace Time  [  ]
Additional Veterans (if using 8x8 or 12x12) use back of page if needed                       First Veteran                   Second Veteran                   Third Veteran
Name of Veteran:
Branch of Service:
Campaign:
If the Veteran did not serve during a military conflict the Campaign will be left off of the paving stone.All Winthrop Veterans of honorable service to their country are eligible and encouraged to participate in this project
Make checks payable to: WINTHROP VETERANS MEMORIAL
C/O Town of Winthrop
17 Highland Avenue
Winthrop, Maine 04364
All donations are Tax Exempt
E-Mail address Winthrop.Vets.Memorial@gmail.com
paver selection
No. Pavers ______    4 x 8  $60.      No. Pavers ______     8x8  $110    No. Pavers ______    12x12  $190

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