|
Your Name:
____________________________________________________
Indicate name as you would like it printed on the flag medallion
Address:
____________________________________________________
Address commemorative medallion will be mailed to after the event
Phone Number:
____________________________________________________
Email:
____________________________________________________
Check #:
_______
Name of Your Hero:
____________________________________________________
Flag Sponsorship ($50)
_______
Includes commemorative medallion
Flag Sponsorship, commemorative medallion & 4-piece coaster set laser engraved with your hero's name ($90)
_______
Please contact the Town of Monroe Supervisor's Office at 845-783-1900, extension 104 or via email at jschnaars@monroeny.org with any questions.
| 
