Veterans Plaque Order Form |
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| Please be familiar with Plaque Criteria/Eligibility before filling out this form to reduce delays in processing. |
A good, quality photo is needed for an individual plaque order. You can send an original photo and it will be returned to you. You can also scan and e-mail the photo to orders@soledadmemorial.com in a jpg format. |
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Please use separate form for each order. |
| Plaque Placement Is Limited Due To Demand |
Order |
Size |
Price |
Tax Deductible Amount |
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16" x 8" Plaque |
$1,500 |
$1,350 |
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Add Picture in Picture |
$50 |
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12" x 8" Plaque |
$1,000 |
$900 |
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Add Picture in Picture |
$50 |
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8" x 8" Plaque* |
$600 |
$540 |
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Add Picture in Picture |
$50 |
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*Please note the plaque mounting locations for the 8x8 plaques are extremely limited and will be mounted at, or near, the bottom of the walls. |
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| Individual plaques allow for one picture. The picture in picture option provides one picture laid on top of another picture within the same Primary Photo |
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Order |
Size |
Price |
Tax Deductible Amount |
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8" x 8" Plaque* |
$150 per name (Mixed Families) |
$135 |
Due to the fact that seven names must exist for production of the Mixed Families Multi-Name plaque, the wait time could be more than two years. |
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8" x 8" Plaque* (dedicated to one group family) |
$1,050 (2-7 Names) |
$945 |
Size |
Unframed Price |
Framed Price |
Tax Deductible Amount |
16" x 8" Glossy Proof |
$25 |
$160 |
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Optional Shipping |
$10 |
$25 |
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12" x 8" Glossy Proof |
$25 |
$155 |
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Optional Shipping |
$10 |
$25 |
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8" x 8" Glossy Proof |
$25 |
$145 |
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Optional Shipping |
$10 |
$25 |
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Order |
Size |
Price |
Tax Deductible Amount |
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Silk Flag |
$80 |
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Flag Case with Silk Flag |
$180 |
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Optional Bronze Plaque |
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Dark Wood |
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Light Wood |
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Shipping |
$35 |
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Ceremony |
Available to be presented by a Mt. Soledad veteran volunteer for minimum donation of $75 to the Association. We try to do them on Saturdays between 10AM and 3 PM. |
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Special requests, please identify |
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Order |
Qty |
Size |
Price |
Shipping |
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American Flag with 5x7 Flag Certificate |
$80 |
$5 |
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Mt Soledad Memorial Association Hat |
$15 |
$5 |
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USA License Plate Covers |
$15 |
Included |
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Plaque Certificate |
$5 |
Included |
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Flag and Plaque Certificate |
$5 |
Included |
Veteran's Information |
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Veteran's Full Name |
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Rank or Rate |
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Branch of Service |
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Conflict (WWII, Vietnam, etc.) |
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Medals, Ribbons, etc. (Optional) |
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Choice of Symbol (Choose One) |
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United States Flag |
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Branch of Service Insignia |
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Other/Symbol |
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Veterans military experience. |
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The statement cannot exceed 25 words and must be directed
to the veteran's war record that "tells
the story" of the veteran. Do not list what he/she thought
of the service and his lineage (father, son, daughter, etc), but tell
what he/she did in the service to our country. |
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Donor's Information |
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| Donor's Full Name |
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Address |
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Address 2 |
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Apt No |
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City |
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State |
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Zip Code |
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| Phone No |
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Alternate Phone No |
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Fax No |
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e-mail address |
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Payment Information |
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Check (payment enclosed) |
Make check payable to Mt. Soledad Memorial Association, Inc. |
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Today's Date |
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Charge My: |
Visa Master Card |
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Card Number |
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Expiration Date |
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CVV No |
Click Here (explanation opens in new window) |
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Signature:___________________________________________________________________ |
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Mail To or Fax |
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Mt. Soledad Memorial Association, Inc. |
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6437 Caminito Blythefield, Suite B |
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La Jolla, CA 92037 |
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Fax: 858-459-2485 |
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Please tell us what prompted you to purchase a plaque: |