Memorial Walls - Niche Request

Memorial Walls - Niche Request

St. Thomas More | Manhattan, KS
Name of Purchaser*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Niche plaques will include:
- Cross icon
- Two lines for Name. Limit of 12 Characters per line
  - Line 1: First name (optional middle name or initial)
  - Line 2: Last name
- Date of Birth
- Date of Death
Plaque - Name Line 1*
12 Characters per line (up to 2 lines for the name)
Plaque - Name Line 2*
12 Characters per line (up to 2 lines for the name)
Plaque - Date of Birth*

MonthDayYear
Date
Plaque - Date of Death (if applicable)

MonthDayYear
Date
Requested Niche (Example: E-2-6)
Wall Letter - Row Number - Column Number
**Please note that niches requested are not guaranteed and are sold as available.**
Should be Empty: