Riverfront Freedom Memorial Order Form

First Name *

Last Name *

Phone Number *

Email Address *

Choose Your Paver Size *

Bronze Level - 4"x8" - $100 Silver Level - 8"x8" - $225 Gold Level - 16"x16" - $1,000 Patriot Level - 24"x24" - $2,000

Paver Placement (Paver is placed in the location of the branch indicated) *

Army Air Force Navy Marines Coast Guard Other

Upload Paver Engraving Form Here *

East Peoria Chamber of Commerce