Request for a Commemorative Plaque

St Macartan’s Catholic Church, Mornington

REQUEST FOR A COMMEMORATIVE PLAQUE
I/We request that the office staff arrange for the casting of a bronze plaque on my/our behalf. Details of the person/s to be commemorated and requested wording are detailed in the box below. The cost of the plaque, with GST, postage/delivery charges included, will be shown on a quotation accompanying a proof of the plaque returned for my approval. Upon payment by Cheque, Cash or Direct Deposit to St. Macartan’s Parish according to the payment details below. The stated amount on the quote and the approved proof will be returned to the foundry for casting. You will be advised when the plaque has been returned and fixed to your brick in the Memorial Wall.
Name of Person ordering Plaque/s
Surname:
Given Names:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Number
Please enter a valid phone number.Format: (000) 000-0000.
Number of Purcashed Brick:
Signature:
Date:

DayMonthYear
2 digit day, 2 digit month, 4 digit year
REQUESTED WORDING FOR A PLAQUE

Please remember: No more than 29 Characters to a line – there are six lines
Line 1
Line 2
Line 3
Line 4
Line 5
Line 6
Payment Details:

Cheque payable to: St. Macartan’s Parish Church Account

c/o Parish Office

4 Drake Street, Mornington VIC 3931

Cash payment can be made with return of this form to the Parish Office during Office hours: 9.00am – 4.00pm (Tuesday to Thursday)

Direct Deposit can be made to: St Macartan’s Parish Church Account BSB: 083-347, Account No: 547 373 281.

Please email the Parish Office: Mornington@cam.org.au to notify that you have made payment.
Should be Empty:

St Macartan’s Catholic Church, Mornington