Wall of Honour Tiles Order Form

wallofhonourSAMF Wall of Honour Form
Fill out this Secure Online form below


You may call  
Phone toll-free to 1-888 497-7779
Local: 461-0062

Email: Province / State:
Name: Postal / Zip Code:
Address: Phone Number:
City: Fax Number:

Tile Option:
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Option A
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Option B
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Option C or D
Please select option:  
I am paying by:
Card Number:
Expiry Date: Month   Year
3 Digit Security Number on Back of Card:


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The colour of the tile will be ‘Belmont Rose’. If the

submission requires any alteration, the subscriber will
be contacted by phone or email by the coordinator for
further discussion. REMEMBER TO COUNT THE SPACES!

Tile Description
Describe your engraving details in the space below.
Count the lettering for each line as described in our cover page.
Please check accuracy before sending - we are not responsible for any misspelled words.
We will contact you on receipt and review of your order.


Please check engraving details for accuracy before sending.
We cannot be responsible for misspelled words on your order form.

For further information, please call the SAMF Secretary: Toll Free: 1-888-497-7779 or (902) 461-0062 | 
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

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