Columbia, IL · Monroe County
Shoemaker School Commemorative Plaza Brick Application
This form lets people order an engraved commemorative brick for the Shoemaker Schoolhouse plaza in Columbia by providing purchaser details and inscription text.
What this form is
Use this application to order a commemorative brick engraved for the paved area in front of the Shoemaker Schoolhouse. The form asks for the purchaser’s name, address, phone numbers, and inscription lines, with limits of 14 letters or spaces per line. It lists a small brick at $75 and a large paver at $200, and notes that engraving occurs approximately three to four times per year.
Who needs it
Anyone ordering a small brick or large paver for the Shoemaker School Commemorative Plaza should complete this form and provide payment.
How to submit it
Return the completed form and payment to City of Columbia (Memorial Brick Order), 208 S. Rapp Ave., Columbia, IL 62236; make checks payable to City of Columbia.
About notarization
This form is completed without a notary; it lists no notarized attachment or sworn step, so the signer just signs and dates it.
How to submit this form
- 1
Download The Application
Download the Shoemaker School Commemorative Plaza Brick Application.
- 2
Complete The Form
Enter the orderer's name, address, phone numbers, and inscription within the listed line limits.
- 3
Prepare Payment
Include payment and make checks payable to City of Columbia.
- 4
Submit The Order
Return the form and payment to City of Columbia (Memorial Brick Order), 208 S. Rapp Ave., Columbia, IL 62236.
Frequently asked questions
- Do I need a notary for the Shoemaker School commemorative brick application?
- No. This form has no notary block and lists no notarized attachment or sworn step; the signer just signs and dates it.
- How do I submit the brick application?
- Return the completed form and payment to City of Columbia (Memorial Brick Order), 208 S. Rapp Ave., Columbia, IL 62236. Checks should be payable to City of Columbia.
- What information does the application ask for?
- It asks for the orderer's name, address, phone numbers, and the inscription text for the selected brick or paver.
- How much does a commemorative brick or paver cost?
- The form lists a small brick for $75 and a large paver for $200. Each inscription line allows a maximum of 14 letters or spaces.
Need something notarized?
This Shoemaker School Commemorative Plaza Brick Application doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.