Inscription Form | Most Worshipful Prince Hall Grand Lodge of NY

Contact Information

Name

First

Last

Email

Order Number:

This is the number from your online order receipt.

Phone Number

Inscription Details

Let's get the details of what you want to have inscribed on the plaque.

Line 1:

Choose your first line of text:

In Loving Memory Of:
Donated By:
Dedicated To:

Line 2:

Line 2 Dedication Section

Name of Person or Entity this plaque is dedicated to:

Here are some examples:
a) RW John S. Doe
b) Bro. Gerald E. Smith
c) PGM Robert D. Jones
c) The Brothers of ABC Lodge No. 123
d) The Members of the First Masonic District

Name of Person or Entity making the dedication:

Here are some examples:
a) From RW John S. Doe
b) From Bro. Gerald E. Smith
c) From PGM Robert D. Jones
c) From The Brothers of ABC Lodge No. 123
d) From The Members of the First Masonic District

Confirmation

I acknowledge that upon submitting this form, the details in this form are accurate and the Grand Lodge is not responsible for errors that were submitted by the purchasing entity.

Blue Room Seat Plaque Inscription Form

The Prince Hall Grand Lodge Blue Room Seat Plaque Fundraiser Inscription Form

Contact Information

Inscription Details

Line 1:

Line 2:

Line 3:

Line 2 Dedication Section