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Fallen Firefighter Memorial

Brick Order Form

Purchase a Commemorative Brick to be placed along the FALLEN FIREFIGHTER MEMORIAL

Located Outside of Engine 2's Quarters
711 West Wells Street
Milwaukee, WI 53233

Sponsored by:
Milwaukee Fire Historical Society, Ltd.



$100.00 Per Brick

Complete Order Form And Return With Check or Money Order

Make Payable To:

Milwaukee Fire Historical Society, Ltd.
711 West Wells Street
Milwaukee, WI 53233
Attention: Jim Ley


                    Name: __________________________________________________________


                   Address: ________________________________________________________



                  Phone Number/E-mail Adress:______________________________________

In the boxes below please print the name you would like on your brick, the number of boxes shown
is the maximum amount of letters per line per brick. (12 characters per line-spaces and hyphens count)


Thank You for Your Order

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