Sisters of Charity of Saint Elizabeth

Please type or print clearly. Donors usually put their own names or "In Memory" or "In Honor" of a loved one.

This bronze covered book is 12"x 16" and can hold up to 6 brass plated pages with a total of up to 2,400 names. Please be assured we will make every effort to have the plate engraved exactly to your wishes.

Samples:
"John and Mary Jones" or "In Memory of John Smith" or "In Honor of Mary Doe"

Blessing Cup Society Engraving Form

Please type or print name as you would like it to be engraved:

Please provide the following information:

Name: ______________________________________________________________

Address: ____________________________________________________________

City: ________________________________ State:______ Zip: ______________

Phone: ( ______ ) _____________________________________________________

Email Address: ________________________________________________________

Please return this form with your check of $500 or more to:
Sisters of Charity of Saint Elizabeth
P.O. Box 476
Convent Station, NJ 07961-0476