Tribute Tile Sign Order Form

You can now permanently recognize your family pet, loved one, business, school, or other group through a personalized tile on our new clinic sign! This is a great way to show your support for the St. Augustine Humane Society to the hundreds of community members who visit our office every year.

Contact Information

Name *

First Name

Last Name

Email *

Verify Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Tribute Tile Information

Paw Print *

I need an impression kit to make a paw print.

Please use a stock paw print for my tile.

Do not use a paw print.

Dog or cat? *

Dog

Cat

The paw print impression kit can be picked up from the St. Augustine Humane Society at 1665 Old Moultrie Road between 9:00am and 4:00pm Monday through Friday.

Paw print sizes will determine the line spacing and letter size. Large paw prints will only allow for one line of text. We use varied sizes of lettering, so fewer characters allow for a larger inscription.

Engraving - Line 1 (10 Characters Max) *

Maximum of 10 characters including spaces

Engraving - Line 2 (10 Characters Max) *

Maximum of 10 characters including spaces

Engraving - Line 3 (10 Characters Max)

Maximum of 10 characters including spaces. Only for Tribute Tiles without paw prints.

Tribute Tiles *	Quantity
$150 - Tile for Tribute Sign

Duplicate Keepsakes	Quantity
$75 - Duplicate Tiles (Can only be purchased after Tribute Tile has been selected)

Would you like to notify someone of this gift? *

Yes

Name of person to notify *

First Name

Last Name

Message to Person to Notify

Address of Person to Notify

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email of Person to Notify

Verify Email

Phone of Person to Notify