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Tribute Stone Order
Each tribute stone can be engraved with up to four lines, 13 characters including spaces and punctuation per line which can include anything from the persons name, date of birth, date of passing, nickname, hometown and/or acknowledgement of club association.
Width: 9 inches ~ Height: 6 inches ~ Lines of text: 4
Disclaimer: The Wisconsin Motorcycle Memorial reserves the right to decline any stone order that includes profanity and/or obscene text.

Tribute Stone Order Form

Purchasers Name *

First

Last

Purchasers Address *

City *

State *

Zip *

Purchasers Phone # *

Purchasers Email *

Tribute Stone for: *

First

Last

Nickname *

Birth Date *

Date of Death (if applicable) *

Club Association *

Is This Individual A Veteran? *

Yes No

If "Yes" Branch of Service *

Do you give the Wisconsin Motorcycle Memorial permission for the following:

Post tribute stone information and/or pictures on our website and/or Facebook page: *

Yes No

Take pictures/video of the stone placement service: *

Yes No

Stone Placement Information:

Will you attend stone placement *

Yes No

Do you plan to have a group or club ride to Memorial Park for the stone placement *

Yes No

What is your preferred date for stone placement *

**Please Allow 14 Days for Stone Delivery from Date of Order or Receipt of a Check Payment.**

What is your preferred time for stone placement *

Stone Engraving Information:
Note: All text will be centered on the stone.
Each line is limited to 13 characters including spaces.

Line 1 *

Line 2 *

Line 3 *

13 characters only

Line 4 *

Special Requests *

Payment Options:
$150 per stone

Choose One *

Check Paypal

Email Address for Paypal Invoice *

Additional Comments/Requests: *

Submit

Tribute Stone Order Form

Designed By:
The Wisconsin Motorcycle Memorial Park

© ALL RIGHTS RESERVED 2001 • N.E.W.B.A. - Wisconsin Motorcycle Memorial, 4758 Mathey Road, Sturgeon Bay, WI 54235 • www.wimotorcyclememorial.org

Tribute Stone Order Form

Designed By: The Wisconsin Motorcycle Memorial Park

© ALL RIGHTS RESERVED 2001 • N.E.W.B.A. - Wisconsin Motorcycle Memorial, 4758 Mathey Road, Sturgeon Bay, WI 54235 • www.wimotorcyclememorial.org

Designed By:
The Wisconsin Motorcycle Memorial Park