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Individual stones cost $280.00 and can be paid for using check, money order, or credit card
(VISA and MasterCard). Please fill out the
below form, print it out, and mail
the completed application and your
payment to:
National Ranger Memorial Foundation, Inc.
P.O. Box 53369
Fort Benning, GA 31995
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Application |
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Purchaser's Information: |
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Street Address
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Phone (ex. 555-555-5555)
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Email
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Ranger's Information: |
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Unit to Appear (20 characters or less including spaces)
Click here to review
examples of appropriate unit
designations |
Comments:
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Qualification Criteria: |
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Proof of Service: |
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Payment Information: |
Amount
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Payment Type
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Name on Card
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Mailing Information: |
Mail the
application package and payment to:
National Ranger Memorial Foundation, Inc.
P.O. Box 53369
Fort Benning, GA 31995 |
READ THE FOLLOWING STATEMENT AND CHECK THIS BOX BEFORE CONTINUING: The information I've provided on this form is correct to the best of my knowledge. I understand that knowingly and willfully providing a false statement or misrepresenting the qualifications of the individual to be engraved on the National Ranger Memorial Foundation Monument is a violation of Georgia Code 16-10-20 and Section 1001, Title 18, U.S. Code and subjects me to prosecution punishable by a fine, imprisonment, or both.
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