Honor Brick Application Instructions

The Friends of Lafayette County Veterans Memorial is now accepting applications to purchase memorial bricks honoring Lafayette County veterans.

A total of 200 brick spaces are currently available. Each brick is $300.
Do not submit payment with your application.

To be eligible, the honored veteran must have been a native of or a permanent resident of Lafayette County and have been honorably discharged. A DD-214 or equivalent separation papers is required and must be submitted with the application.

If more than 200 eligible applications are received, bricks will be awarded through a computer-generated lottery.

Application deadline: April 9, 2026 Payment deadline (for selected applicants only): May 9,2026

Payment will be requested only after eligibility has been verified and the application has been approved. Applicants not selected in the lottery will be retained for future consideration as the project expands.

Applications may be submitted online or by mail:

Jennifer Jellum
c/o Lafayette County Courthouse
1001 Main Street
Lexington, MO 64067

Information from mailed applications will be entered into the database and included in the computer-generated lottery.

Applications will be accepted through April 9, 2026, please complete the form.

Please enable JavaScript in your browser to complete this form.

Was or is the Veteran a permanent resident of Lafayette County, Missouri? *

• Yes
• No

Was the Veteran born in Lafayette County, MO? *

• Yes
• No

File Upload for DD-214 or Equivalent Discharge Papers *

Drag & Drop Files, Choose Files to Upload

Documents submitted with this application, including DD-214 or equivalent discharge papers, are considered confidential and will be used solely for eligibility verification for the Lafayette County Veteran Memorial Project. Access is limited to authorized committee members. Documents will not be shared, published, or distributed and will be stored securely in accordance with applicable privacy and record-retention practices.

Is your Veteran a Gold Star Veteran? *

• Yes
• No

Veterans Name *

First

Last

Veterans Date of Birth *

Month/Day/Year

Branch of Service: *

• Army
• Navy
• Air Force
• Marine Corps
• Coast Guard
• Space Force

Dates of Service Example 1969-1979 *

Rank

Submitters Name *

First

Last

Submitters Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Subitters Phone *

Submitters Email *

By Checking Yes, you agree to the terms described below. *

• Yes

I understand that applications will be reviewed after the submission window closes on April 9, 2026. A payment of $300 will be requested only after eligibility has been verified and approval is granted, and if more than 200 eligible applications are received, a computer-generated drawing will be
conducted to select the 200 honorees for placement.

Memorial Inscription Line #1 (14 characters including spaces) *

Maximum 3 lines on a 4” x 8” inscription. No logos or emblems permitted. 14 characters per line (including spaces).

Memorial Inscription Line #2 (14 characters including spaces) *

Maximum 3 lines on a 4” x 8” inscription. No logos or emblems permitted. 14 characters per line (including spaces).

to Phone including

Memorial Inscription Line #3 (14 characters including spaces) *

Maximum 3 lines on a 4” x 8” inscription. No logos or emblems permitted. 14 characters per line (including spaces).

Submit