For more information, please contact: Mail completed form to: “Ephrata Honors” Stephanie Harley 717-875-1945 or [email protected] c/o Ephrata Merchants Association Amy MacKenzie 717-575-3982 Ephrata Honors … Banner Program P.O. Box 31 Ephrata, PA 17522 Make checks payable to: Ephrata Merchants Association, “Ephrata Honors” in the memo line If you would like your photo returned, please include a self addressed stamped envelope; otherwise please send a good copy of the photo. Disclaimer / Release: Photos can also be scanned as a jpeg and emailed to: I hereby grant the use of the enclosed / [email protected] emailed photo to the 2015 “Ephrata Honors” To order your banner online go to: www.ephratamerchants.com Banner Program, without payment or other consideration. We will offer two opportunities to assist I stipulate that all data is accurate, to the you with your photo and paperwork. best of my knowledge. Visit us at the Ephrata VFW 141 S. State I have secured permission form the person in Honor a community Street, Ephrata 733-9904 the photo (if living) to display their image and member who serves or has served in the on the following dates: • Monday, June 1 noon - 4:00 pm • Tuesday, July 7 6:00-8:00 pm military service data on a banner. Printed Name:_________________________ Signature:_____________________________ Bring in your photo and we’ll scan it for you and make sure the text is correct. Date:________________________________ Ellen Rose McCarthy, USAF US Armed Forces Sponsored by The Ephrata Merchants Association and Cocalico Valley (Ephrata) VFW Post 3376 Honor a past or present member of the US Armed Forces. Please complete form and return with a photo of the service member you wish to honor. Sponsorship is $160.00 per banner. There are a limited number of banners available. We will accept orders until August 14, 2015. Proceeds from the banner program will support the many Veteran Assistance Programs sponsored by Cocalico Valley VFW Post 3376 & the Ephrata Downtown Holiday Lights, sponsored by the Ephrata Merchants Association. The banners will be part of the Ephrata Downtown Banner rotation. The unveiling ceremony will be held Sunday September 13, 2015 at 3:00 pm on Main Street, Ephrata. More details will be provided about the ceremony closer to the event. Sponsor’s Name ____________________________________________ Address:___________________________________________________ Phone:________________________________Email: _____________________________________ Name of Military Member as it should appear on the banner ______________________________________________________________________________ Branch of Service:____________________ Dates Served (if known):______________________ Rank (if known):____________________ Additional Data: example: Era Served, such as WWII, Vietnam, Korea, Cold War, etc, or KIA date / location ___________________________________ Name of dedicating family as it appears on the banner __________________________________________________________ Options: I do not know a service member, but wish to donate to the program, to offset the cost of a banner for another family. Name: ______________________ Donation: $______________ Businesses who sponsor a service member may be listed on the banner: Business Name:______________________________________ Please see reverse side for additional information Above is the Sample Banner Size of actual banner is 42’’ x 84’’ Your Text Will Vary based on data you supply
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