Wildrose Virtual Veterans Cemetery Virtual Plaque Order Form

Howard H. Colter USN/WWII-Korea 1921 - 2001 VFW Post # 836 - MI

(Sample Veteran's Plaque)

Warren C. Teller USMC / WWII 1925 - 2001 VFW Post # 796 - Port Huron,MI

(Veteran's Plaque with Picture)

To order your FREE virtual Veteran Memorial Plaque, fill in the required areas below. Our goal is to develop a national, state-by-state, post-by-post listing of deceased Veterans and dedicate our Memorial Plaques in their honor.
Select the Veteran's Military Service Branch (check one).
U.S. ARMY U.S. AIR FORCE U.S. NAVY U.S. MARINE CORPS U.S. COAST GUARD U.S. MERCHANT MARINE *Other-please specify below
Name of person placing order:
Your e-mail address:
*Other Branch of Service:
War/Conflict (WWII,Korea,etc.):
Deceased Veteran's Full Name:
Year Born:
Year Passed Away:
VFW Post#:
American Legion Post#:
AmVets Post#:
Other Association:
Post location City and State: , Select A State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Do you wish to add a picture?       YES    NO If "YES", send a picture as an attachment to an e-mail by clicking "Contact Us" (below) and put the veteran's name in the subject of the letter.

Please use the space below for comments or "MULTIPLE SUBMISSIONS". This can save you time if you can cut-and-paste from your database or word processor.
Enter the exact data from the form above for each Veteran's submission ("person ordering" information needs only to be filled out once if you are associated with a Veteran's group).

We will contact you by e-mail when your virtual plaque is ready for viewing.

Please click the button below to help us continue our services!