Directions:

1. Complete each row – Maximum of 18 characters per row. Suggestion: Rank, Name, Branch of Service, Campaign, Dates of Service.
 
2. Fill in contact information so that we can communicate with you about including detaild information about your Veteran on the website.
 
3. Make your $60 Donation via the Paypal/Credit Card Donation button:
 
4. Press Submit on the bottom of this page. Please note that your Submission can not be processed until we recieve payment.
 
If you prefer, you can Download the Paver Order form and Mail it to: Cohoes Veterans Memorial Committee, P. O. Box #346, Cohoes, NY 12047 with your check in the amount of $60.00 payable to – Cohoes Veterans Memorial Committee Inc.
 
 
*Please Note: There cannot be a guaranteed location of the Pavers and both the Town of Cohoes and
Cohoes Veterans Memorial Committee reserve the right to relocate a brick if deemed necessary
Download Paver Order Form
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Contact Name
Address
Phone
Email
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