Lewiston, NY · Niagara County

No notary required

Lewiston Peace Garden “Memory Lane” Brick Application

This application lets residents, businesses, and other purchasers request an engraved brick for the Lewiston Peace Garden and provide the inscription.

What this form is

Use this application to purchase an engraved brick as a lasting gesture or commemoration for a friend, loved one, or yourself. It asks for the purchaser’s contact information, an inscription of up to 13 letters per line, stone size, payment amount, signature, and date; inscriptions will appear as indicated on the form.

Who needs it

Anyone who wants to purchase an engraved small or large stone for the Lewiston Peace Garden should complete this application.

How to submit it

Send the completed application and a check payable to Village of Lewiston to 145 N. 4th Street, Lewiston, NY 14092, or pay online at villageoflewiston.net. The form lists (716) 754-8271 for more information.

About notarization

This application is signed and dated without a notary; no notarized or sworn attachment or related step is mentioned.

How to submit this form

  1. 1

    Download The Application

    Download the Lewiston Peace Garden “Memory Lane” brick application.

  2. 2

    Complete The Application

    Enter purchaser contact information and the inscription, allowing no more than 13 letters per line.

  3. 3

    Choose A Stone

    Select the small or large stone and enter the amount enclosed.

  4. 4

    Sign And Submit

    Sign and date the application, then mail it with a check or pay online as indicated on the form.

Frequently asked questions

Do I need a notary for the Lewiston Peace Garden brick application?
No. The application has a signature and date line but no notary block. The form does not mention any notarized or sworn attachment or related step.
How do I submit the Lewiston Peace Garden brick application?
Mail the completed form and a check payable to Village of Lewiston to 145 N. 4th Street, Lewiston, NY 14092, or pay online at villageoflewiston.net.
What information does the application ask for?
It asks for purchaser contact information, an inscription of up to 13 letters per line, stone size, payment amount, signature, and date.
What stone sizes can I choose?
The form lists a small 4-by-8-inch stone with a three-line inscription for $100 and a large 8-by-8-inch stone with a six-line inscription for $185.

Need something notarized?

This Lewiston Peace Garden “Memory Lane” Brick Application doesn’t need a notary — but if you have another Lewiston form that does, a commissioned online notary can help.