City of Austell
Veterans Memorial Park
City of Austell
Veterans Memorial Park
Complete the following information:
Requestor Name: __________________________ Date: ________________________
Address: ________________________________________________________________
City/State/Zip Code: _______________________________________________________
Telephone Number: (_____) _______________ E-Mail: _________________________
Please mail or fax your order to:
City of Austell Community Affairs
5000 Austell-Powder Springs Road, Suite 101
Austell, Georgia 30106
Office: (770) 944-4309 Fax: (770) 944-4311
You may place your order online. Please visit www.austellga.gov.
Orders are being accepted for memorial brick pavers that will be installed at the Veterans
Memorial Park. Orders may be placed at the City of Austell Threadmill Complex located at
5000 Austell-Powder Springs Road, Suite 101. The cost for each brick paver is $50.00 and
will consist of three (3) rows with each row containing up to 14 letters, numbers, symbols, or
spaces. If ordering more than one brick, please enclose a separate order form for each brick
paver requested.
Please use the boxes below to show how you wish the brick paver to be inscribed.