Memorial Form


El Dorado County veterans, their families or friends may buy memorial bricks, stones, placards and benches honoring the veterans’ service at the Veterans Monument. Living veterans are often memorialized at the Veterans Monument.


Veterans of the United States Armed Forces (as defined by the U.S. Department of Defense) who have lived in El Dorado County (prior to, during or following military service) and veteran relatives and ancestors of residents of El Dorado County may be memorialized at the El Dorado County Veterans Monument.

To apply to purchase a memorial, fill in the required information and click [SUBMIT].

Proceeds benefit scholarships for El Dorado County veterans and their families, provide assistance to county veterans, and contribute to improvements at the Veterans Monument.

MEMORIAL APPLICATION

Veteran’s Information:

Veteran’s Rank at Separation/Retirement:

Veteran’s First Name:

Veteran’s Last Name:

Branch

___ U.S. Army

___ U.S. Marine Corps

___ U.S. Navy

___ U.S. Air Force

___ U.S. Coast Guard

___ U.S. Merchant Marine

Wars:

___ WWII

___ Korea

___ Vietnam

___ Gulf

___ Iraq

___ Afghanistan

___ Other __________________

Medals*:

___      Medal of Honor

___      Distinguished Service Cross (Army)

___      Navy Cross (Navy and Marine Corps)

___      Air Force Cross

___      Coast Guard Cross

___      Silver Star

___      Bronze Star

___      Purple Heart

*Must provide proof of award, e.g., DD-214 or other U.S. Dept. of Defense certification of award, by mailing a copy: Friends of the Veterans Monument, 685 Placerville Dr., Placerville, CA 95667. All awards must be confirmed as valid by Friends of the Veterans Monument.

 

Applicant Information (will be used to communicate with applicant and confirm accuracy of information):

 

Name of Applicant:

Relationship to Veteran: ___ Self   ___ Other: _______________________

Address:

City:                                                                       State:                     Zip:

Phone:

Email:

 

I hereby certify that the above information is true [SIGNATURE BLOCK]. [DATE]

 

Choose One (prices may vary and include proofing, engraving and installation):

 

___ Perpetual Memorial Brick – $150 (Must be a qualified Veteran of the U.S.

Armed Forces, as determined by Friends of the Veterans Monument. Veteran’s Information may need to be edited to fit brick.) Proceeds benefit scholarships for veterans and their families.

 

___ Perpetual Memorial Stone – $500 (Must be a qualified Veteran of the U.S.

Armed Forces, as determined by Friends of the Veterans Monument. Veteran’s Information may need to be edited to fit stone.) Proceeds benefit scholarships for veterans and their families.

 

___ Perpetual Memorial Bronze Plaque – Suggested price $2,500 to $5,000, depending on size and design. (To qualify, must have Silver Star or higher precedence medal, have died in combat, or have attained the rank of E-9 or O-7 or higher). Proceeds benefit the Veterans Monument and El Dorado County veterans.

 

___ Perpetual Granite Memorial Bench – Suggested price $5,000, depending on wording and design. (To qualify, must have Silver Star or higher precedence medal, have died in combat, or have attained the rank of E-9 or O-7 or higher, also eligible to veteran’s organizations, military commands or units with significant representation [10 or more] within El Dorado County). Proceeds benefit the Veterans Monument and El Dorado County veterans.

 

Following receipt of an Application, Friends of the Veterans Monument will contact applicants to arrange for payment and confirm details of the application and installation.

 

[SUBMIT]