Chapter 10 2019 Sponsor Plaque Order Form

The Police Unity Tour is always grateful to our sponsors and Chapter 10 is pleased to assist our members in acknowledging them.  All 2019 donations over $500 will receive a free plaque, however you must order the plaque and we will verify the donation.  Additional plaques can be purchased by any individual member at your cost regardless of the donation. Price of those plaques will be set at the September meeting.

Please complete the following order form to order your plaque.  The plaques will be picked up at the first meeting after delivery (typically January) and distributed to the sponsor by the individual member.  No shipping will occur unless the Chapter Member is out of state.  No incomplete forms will be accepted.  

For additional plaques, a separate form will be emailed to you to fill out credit/debit card information.  

This order form will be closed after November 1st, 2019.  The plaques will be handed out at the February 2020 Meeting.   

Member Information

Company Information

Please take the time to review and use proper capitalization for the following question as all requests are final.  

The following is how I/we are requesting to engrave the Plaque:


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Please indicated the number of plaques to be ordered.  The first is free if the donor submitted an individual or collective team donation over $500.  Your team may choose to order additional plaques at your expense for donations under $500 or for additional donors on the same donation.  


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