Sobey Wall of Honour Order Form

2019 Brick Installation Dates:

March - if order and payment received by February 8, 2019
June - if order and payment received by May 10, 2019
November - if order and payment received by September 27, 2019
December - if order and payment received by November 1, 2019

(Note: Early brick installation is available for an additional fee, time permitting. If you are interested, please call Maria Almeida, Donor Relations Manager, at 902-420-6656 for details.)

Step 1 of 2 (Information)

Purchaser’s Information

Title

First Name *

Last Name *

Address *

City *

Province or State *

Country

Postal Code *

Email *

Home Phone *

Work Phone

Relationship to Recipient(s)

How did you hear about the Sobey Wall of Honour? *

Sobey Wall of Honour Information

Person(s) Name(s) *

Guidelines: Maximum of 35 characters including spaces and punctuation. No symbols, titles, dates or countries are permitted.

Gift Card is required *

Occasion

Personal Message and From Whom

Mail Card

Recipient(s)’ Information

Recipient(s)' Name *

Address

City

Province or State

Country

Postal Code

Phone

Do you have a connection to Pier 21?

Yes

If yes, please specify your connection to Pier 21 / Other Gateway *

With your approval, your personal message, if provided above, will also be released for the sole use of the Canadian Museum of Immigration at Pier 21. It may be shared in-house, online and electronically. This gives Canadian Museum of Immigration at Pier 21 permission to share your message but not your address. Please let us know if you have any questions.

Approval *

Leave this field blank