RMF - Purchase a Stone

Purchase Stone Application

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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.

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

Application

Purchaser's Information:

First name	M.	Last name	Suffix

Street Address

City	St	Zip

Phone (ex. 555-555-5555)

Ranger's Information:

First name	M.	Last name	Suffix

Unit to Appear (20 characters or less including spaces)

Click here to review examples of appropriate unit designations

Comments:

Qualification Criteria:

Graduate of the U.S. Army Ranger School
Served in a provisional or operational LRP/LRRP company during the Vietnam War
Served in an operational Ranger unit during peace or wartime
Attached to Ranger Unit during combat operations
Awarded the U.S. Army Ranger Tab by General Executive Order for:

World War II Ranger BattalionsMerrills Marauders (5307th Composite Unit-ProvisionalRanger Infantry Companies (Airborne) of the Korean War

Proof of Service:

DD Form 214 - Click here to aquire a copy
Ranger School graduation diploma - Click here for RTB
Special orders awaiting Ranger qualification or service with a Ranger unit
DA Form 1
None available

Payment Information:

Amount

Payment Type

Card Number	Exp. Date
	/

Name on Card

Mailing Information:

Mail the application package and payment to:

National Ranger Memorial Foundation, Inc.
P.O. Box 53369
Fort Benning, GA 31995