Please download and send this application with check or money order with all information requested to:

Lewiston Auburn Veterans Council Inc.

Gerry N. Cain, Treasurer

53 Oxbow Drive, Lewiston, Maine 04240-2137

Veteran’s Memorial Park Granite Benches Application

There will be no more than 10 names per bench (5 on each side) @ 200.00 per name with no more than 27 characters including spaces.

Donors can be of different variations.

One donor could purchase the complete bench at 2,000.00

Two donors would divide it in half at 1,000.00 each.

Four Donors could get together (friends, family etc.) and divide it up at 500.00 each.

It’s an excellent heartfelt and dignified commemorative that last lifetimes.

Please PRINT all information

Name: _______________________________________________________

Address: ______________________________________________________

City: _________________________ State: _______ Zip Code: __________

Telephone Number: _____________________________________________

Engraving should read as: ________________________________________

Check: ___ Money Order: ___ Number: _____________________________

Mail to Treasurer

Gerry N. Cain, Treasurer

53 Oxbow Drive, Lewiston, Maine 04240-2137