Order Stone | Wisconsin Motorcycle Memorial

Purchaser's Information

Purchaser's Name

Street Address *

City *

State/Province *

ZIP / Postal Code *

Phone *

Email Address *

Tribute Information

First Name *

Last Name *

Nickname

Birthdate

Month

Day

Year

Date of Death (if applicable)

Month

Day

Year

Club Association

Was This Individual a Veteran?YesNo

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:YesNo

Take pictures/video of the stone placement service:YesNo

Stone Placement Information:

Will you attend stone placement?YesNo

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

What is your preferred date for stone placement? *

Month

Day

Year

**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? *

Hours

Minutes

Stone Engraving Information

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

Line 1 *0 / 13

Line 2 *0 / 13

Line 3 *0 / 13

Line 4 *0 / 13

Special Requests

Payment Options

$260 Per Stone

Payment Method *CheckPaypal

Additional Comments/Requests

Tribute Stone Order

Price: $260

Disclaimer: The Wisconsin Motorcycle Memorial reserves the right to decline any stone order that includes profanity and/or obscene text.

Engraving Schedule

First Engraving

Second Engraving

Third Engraving

Tribute Stone Order Form