Share your story and become part of the legacy

Ensure your story will be shared for future generations by having it posted under your name on our Virtual Wall of Service. Friends and family will be able to read your story when they view your brick online. There is no additional fee and please allow 8 weeks after the installation/submission date before it is viewable.

Submitter’s Information

Title

First Name *

Last Name *

Address *

City *

Province or State *

Country

Postal Code *

Email *

Home Phone *

Work Telephone

Fax

Relationship to Name(s) on Wall *

Personal Information

Rank and Name on Wall of Service *

Service *

Years of Service

Medals Received

Submitting Photos

If yes, please indicate the number of photos

Photos: Only .pdf, .doc, .jpg and .zip files permitted.
If you have more than one photograph, upload a zip file.
File size must not exceed 5MB
If you need assistance submitting photographs, please contact Maria Almeida

Upload a file

Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png tif psd pdf doc docx zip.

Please describe each photo

Personal Story and or Bio

Personal Information provided on this form is released for the sole use of the Canadian Museum of Immigration at Pier 21. Stories shared above may be added to the Canadian Museum of Immigration at Pier 21 Story Collection and shared in-house, on-line and electronically. Filling out this form gives the Museum permission to share your story but not your address. Please let us know if you have any questions.

Leave this field blank