Request a Memorial Stone Plaque:

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Thank you for your interest in our Memorial Stone Plaque Program!

This is a free program for our families to utilize IN WISCONSIN.

Bereaved families are welcome to fill out this application.

An important note:

the first Stone Memorial Plaque is always free.

but additional plaques will cost $25 a piece.

This is for time and materials to our supplier.

If you are interested, you will need to email our organization up to THREE photos of your loved one.

(We say up to three photos because sometimes the resolution on one photo doesn’t work out the way that we hope).

Please note, just because you fill out this application form does not guarantee a plaque to be mailed.

You must email Photos in order to successfully request a plaque.

If you have any questions, please don’t hesitate to reach out.

Also, please note: all photos of plaques are available on our Facebook page in the memorial stone plaque album according to the year that they were made.

If you would like to email:
bosheavenlyclubhouse@gmail.com
for further assistance, our founder, Amanda Hartwig will be sure to get back with you!

Due to our organization not being nationally funded, please keep in mind this is a program for Wisconsin residents only. (At this time!)

Email *

What is YOUR full name? *

What is the full name of your parent/child(ren) that passed away? *

What is your FULL address? (INCLUDE ZIP CODE)

Please note: failure to include your entire address, will result in incomplete form, and no plaque will be made.

How many plaques are you requesting? Please note the first plaque is free anything additional is $25 a piece. *

Any other important information that you would like us know about?

Please EMAIL

Bosheavenlyclubhouse@gmail.com

maybe later

A copy of your responses will be emailed to the address you provided.

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