Memorial Article Inventory Sheet

DR (do not write in this space)

Full Name

 

Class

 

Cullum #

 

Date of Birth

 

Date of Death

 

Place of Death
(city & state)

 

Remains are

Interred in
(cemetery name, city & state)

 

Cremated / Inurned in
(cemetery or columbarium name, city & state)

 

Cremated / ashes scattered

 

Photo

  Photo Included

  Use Howitzer photo

Next of Kin

Relationship

Street

City

State

Zip

Telephone number

Fax number

E-mail address

Next of kin, PLEASE SIGN ONE of the following:

  Approval for publication in official AOG printed publications ONLY

  Approval for publication in official AOG printed publications and non–password-protected class web page

Additional copies of the ASSEMBLY issue in which the memorial article is published:

Next of kin will receive two complimentary copies; additional copies are $8.00 for first and $6.00 for each additional. Please enclose payment with Inventory Sheet and Memorial. Check (payable to AOG), MasterCard, VISA, and American Express are accepted.

Number of additional copies

Amount $

Form of payment (circle one): Check * / VISA / Mastercard / Amex

Credit card #

Expires

Author of Memorial Article

Relationship to Deceased

Cite the author(s) name at the bottom of the article:     Yes     No

If “Yes,” how it should appear:

 

Street

City

State

Zip

Telephone number

E-mail address

Print this form, fill it out completely, and fax or mail it — with your draft memorial article — to the AOG:

FAX:

845 446-5325

Mailing address:

Association of Graduates
Publications
Attn.: Memorial Articles Editor
698 Mills Road
West Point, NY 10996

* Please enclose with Memorial Article and inventory sheet.