Deterrent Park – Buy a Brick Application

Use the boxes below to compose your personalized brick inscription(s).
Use 1 letter, period, comma or space per box. There are 15 characters per line, and each brick will have 3 lines for a total of 45 characters.  All characters will be engraved in capital letters, and all lines will be automatically centered on the brick.

If you desire a second brick use the spaces below.

I wish my brick to be placed with others from
(ship) (organization) or (company).

     Please include your address and phone number

Name: Address:  City: State: Zip Code: Phone #:

Total bricks ordered: Each Brick: x $40.00 Total Donation:

You may donate any amount you wish over the cost of the bricks.  Each engraved brick is $40.00.
All brick purchases and donations are tax deductible.

Send to:  Pacific NW Submarine Heritage Association
        PO Box 6365 Silverdale, WA. 98315-6365