WALL OF HONOR PLAQUE INSCRIPTION

Central Coast Veterans Memorial Museum

YOUR NAME: _____________________________________

ADDRESS:     _____________________________________

CITY:                _____________________________________

STATE/ZIP:    _______________________________

PHONE:          ____________________                
Email:            ____________________

Inscription: Service: ____________________ (please print clearly)

Please print this form (put the mouse on the form, right click, print), fill in and mail a copy along with your check for $300 made out to: CCVMM

Send to:

CCVMM
Attn: Wall of Honor
801 Grand Avenue
San Luis Obispo, CA 93401

You will be notified when your plaque is completed. If you have any questions, please call the museum at 805.543.1763