It’s very simple to order... just PRINT THIS PAGE and  fill out and mail the form.

NOTE:
You may order more than one plaque, but you MUST place individual orders -- one at a time.
Welcome Home;
    We have something new and beautiful for you to have for yourself or as an In Memory plaque for a loved one. This is available to anyone who would like to purchase it for a recipient of the Silver Rose Award.  Of course all donations go to sustain the Silver Rose Mission. This is truly a very gorgeous addition to your home. It is  8” by 10” and is on a beautiful wood backing. All imprinting is laser engraved on black aluminum as pictured above.

Delivery time is 6 to 8 weeks. The order must be prepaid via check at the address shown below.
The cost is only $50.00 plus $10.00 shipping and handling.
All Donations are Tax Deductible. We are a Tax Exempt 501(c) 3 Non-Profit Group.

You can use up to 3 short lines to say anything you want on this plaque.
 Please be very Specific on the following order form.

Please print a copy of this form, and
mail it to The Order of the Silver Rose with your payment.
Contact info is at the bottom of this form.

Your Name________________________________________________________________
Street Address (sorry no PO Boxes)____________________________________________
City_________________________________State_______________Zip Code__________

Recipients Award Number MUST be included and can be found on the corner of the
Silver Rose Award Certificate or Award Card unless you are a
Pending Recipient and have not yet been issued a  permanent  number and award.
Award Number: ______________ (Unless pending)

Phone number Area & Code(_____)____________Email address___________________

1st. Line (Rank if you wish)__________________________________________________
2nd. Line (Name if you wish)________________________________________________
3rd. Line ( Branch of Service if you wish) ______________________________________

Please mail this application to;
Gary Chenett, National Director ,
The Order of The Silver Rose
9157 Ann Maria
Grand Blanc, Michigan 48439
Phone 810-714-2748 or 810-714-5442     
All Orders Final as written!!!!
Please make checks or money orders payable to The Order of The Silver Rose!