Lake Grove, NY · Suffolk County
Brick Dedication Form
Lake Grove residents and supporters use this form to provide contact details, select dedication bricks, and pay for bricks supporting community beautification.
What this form is
The Brick Dedication Form collects the brick purchaser’s name, address, phone number, email address, and selections for up to three bricks. It lists a cost of $60 per brick and says checks should be payable to the Lake Grove Beautification & Historical Society. The form does not state when the city requires it; it supports the organization’s community beautification work.
Who needs it
People who want to dedicate one or more bricks and support the Lake Grove Beautification & Historical Society can complete this form.
How to submit it
Mail the completed form and a check payable to Lake Grove Beautification & Historical Society to P.O. Box 163, Lake Grove, NY 11755.
About notarization
This document is completed without a notary; it has no notarized attachment or sworn step, and the signer just signs and dates it.
How to submit this form
- 1
Download the Form
Download the Brick Dedication Form.
- 2
Complete the Form
Fill in your name, address, city, state, ZIP code, phone number, and email address, and select brick options.
- 3
Prepare Payment
The form lists a cost of $60 per brick and says to make the check payable to Lake Grove Beautification & Historical Society.
- 4
Mail the Form
Send the completed form and check to P.O. Box 163, Lake Grove, NY 11755.
Frequently asked questions
- Do I need a notary for the Brick Dedication Form?
- No. This form has no notarized attachment or sworn step; the signer just signs and dates it.
- How do I submit the Brick Dedication Form?
- Mail the completed form and a check payable to Lake Grove Beautification & Historical Society to P.O. Box 163, Lake Grove, NY 11755.
- How much does each brick cost?
- The form lists the cost as $60 per brick.
Need something notarized?
This Brick Dedication Form doesn’t need a notary — but if you have another Lake Grove form that does, a commissioned online notary can help.