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2. 
   

   Personalized Pavers

   
   

   Donate $150 to inscribe a name or message on a 5 x 19 paver that will be installed this summer outside of the new City Hall at Millcreek Common. Proceeds will support various public art projects. Deadline to purchase paver is end of day, June 1, 2023. 

   
   

   For a Specialized Plaque, please send an email to dmerkley@millcreek.us and we will send you additional information.

3. 
5. Name*
6. Email Address*
8. Address*
10. City*
11. State*
12. Zip Code*
14. Phone Number*

16. Personalized Message

18. You are allowed 15 characters (including spaces) per line, up to three lines. For uniform formatting purposes we prefer messages are not in ALL CAPS except where necessary.

20. Line 1
22. Line 2
24. Line 3

26. Once your application has been submitted, it will be reviewed. 

    Once your application has been approved, we will send you a link for payment as well as a paver disclosure form via the email provided on the application.

    For further questions, please contact Dan Merkley at dmerkley@millcreek.us.

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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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