APPLICATION
FOR MARKER/PLAQUE
Information about markers and plaques can be found in the Constitution and By-laws, Section 6, page 25.
Date: ______________
Company or Camp: ____________________________________________________
City:
Each blank must be completed as thoroughly as possible.
(1) Suggested title of plaque: ____________________________________________
(2)
Exact location where you propose to place the plaque:
_____________________
_________________________________________________________________
(3)
Do you have permission to place the plaque on your
selected site? ____________
With whom?
Name: _______________________________________________________
Organization: __________________________________________________
Note: It will be necessary to obtain lease or deed upon approval of
application. If a lease with the Church of Jesus Christ of Latter-day Saints is
needed, a lease form must be obtained from our office.
(4) A list of historical pioneer facts about the reason for the plaque must be enclosed with this application.
(5)
Name and address of the Marker Chairperson in charge of
this project.
Name: __________________________ Phone:
_______________________
Address: __________________________________________________
_____________________________
ZIP: _________________
REQUIRED: Signatures of at least three committee members.
______________________________________________
(Name and title)
______________________________________________
(Name and title)
______________________________________________
(Name and title)
NOTE: The International Society of Daughters of Utah
Pioneers will pay the cost of the plaque. The mounting of the plaque, the
monument, and any other expenses are paid by the Company or Camp initiating the
application. Each marker must be sponsored by a local Camp and Company. They
will be responsible for the authenticity of information, perpetual care and
upkeep.
Daughters of Utah Pioneers
Phone:
801.532.6479 FAX: 801.532.4436