Memorial Tile Request Form

Korean War Veterans Memorial
Association of Wisconsin
554 Tyrolian Drive
Green Bay, Wisconsin 54302-5140
Email: The Association

Subject: Memorial Tile Request Form (Please Print)

Donors Name:

________________________________________________________________

Address:

________________________________________________________________

City: _____________________________

State: _______________

Zip: _______________

Phone: ( ______ ) _____ - _____________

Email: ___________________________________

Information to be placed on tile

IN HONOR OF

_____________________________________________________________

OR IN MEMORY OF

_____________________________________________________________

MESSAGE

_____________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

If additional space is needed, use another sheet of paper or the reverse side of this form.

Tiles available are either 6” x 6” or 12” x 12”

6” x 6” tiles allow for 4 lines of 20 characters (including spaces).

12” x 12” tiles allow for 9 lines of 35 characters (including spaces).

If you wish to have an organization’s Logo to the tile, it will cost an additional $50.00. The donor must supply the artwork (black & white only) at the time of the request. A logo or emblem will also limit the message lines placed on the tile.

Donation for a 6” x 6” tile is $250.00 without a logo, $300.00 with logo or emblem

Donation for a 12” x 12” tile is $500.00 without logo, $550.00 with logo or emblem

All wording on the tile request must be approved by the memorial committee.

If a request is found to be inappropriate, the request and donation will be returned to the donor.

This is a very nice way to remember or honor a loved one or friend that served our nation during the Korean War.

Please send a completed request form and your donation to the address listed at the top of this form.

You will be notified by the association when the tile will be placed upon a wall at the memorial park.

Tile orders received by March 31st will be in place for the annual ceremony in June of that year.