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The Circle of Remembrance is in dedication to all Veterans. The Circle contains walkways made of commemorative bricks located on Waltham City Common.
Please fill in the information requested below to purchase a commemorative brick to honor a Veteran of any War or of Peacetime. Each brick will be etched with the Veteran's Name, Branch of Service and years served or serving the United States of America. Upon receipt of this form & payment, an acknowledgement card will be sent to the purchaser.

Purchaser's Information Section

Purchaser's Name: ______________________________________________

Street Address: _________________________________________________

City, State & Zip: _______________________________________________

Phone Number: _________________________________________________

E-Mail Address: __________________________________Date: ___________

Veteran's Information Section
  • Veteran's Name: (up to 15 characters, including spaces)

  • Veteran's Branch of Service: (U.S. Air Force; U.S. Army; U.S. Coast Guard; U.S. Marine Corp.; and U.S. Navy)

  • Years Served (example: 1942-1945)

  • Please circle if Veteran was any of the following:
    POW (Prisoner of War) MIA (Missing in Action) KIA (Killed in Action)

To purchase a brick, please complete this form and attach a check in the amount of $100.00.

Checks are to be made payable to the City of Waltham – Circle of Remembrance and may be sent or dropped off at: City Treasurer's Office -
Waltham City Hall
610 Main Street
Waltham, MA. 02452

ATTN: Circle of Remembrance Committee
If you do not wish to buy a brick but would like to donate towards helping a Veteran or Veteran's family who is unable to purchase a brick; please indicate the amount of your donation $_________.

Thank you,
The Circle of Remembrance Committee

To download the form in PDF format: Circle of Remembrance Form