Pet Memorial Wall Order Form

The Pet Memorial Wall provides a unique opportunity to commemorate the life of your pet. In life, you loved and cared for your pet; in death you are creating a lasting tribute. Funds from the Memorial Wall will assist Lions Foundation of Canada Dog Guides in providing Dog Guides.

The plaques are inscribed with the family name and pet’s name and the family are invited to the annual Pet Memorial service on the 2nd Saturday of June, where they can visit the wall.

The Pet Memorial Wall is located in Breslau, Ontario, on the grounds of the Dog Guide training center, where many of our puppies begin their lives.

Each plaque costs $150.00

A letter and certificate acknowledging your gift will be sent to the pet’s family.

Deadline for this year’s dedication ceremony is April 25, 2025. Any purchases made after this date will be dedicated at the June of 2026 ceremony.

PLEASE ENTER INFORMATION EXACTLY HOW IT IS TO APPEAR ON THE PLAQUE

Pet Name *

Pet's Family Name *

Year Born *

Year Deceased *

PURCHASER INFORMATION FOR YOUR INVITATION TO THE DEDICATION SERVICE

Full name and/or Club *

Email (tax receipt will be sent here) *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

SEND THE IN MEMORIAM CERTIFICATE AND INVITATION TO THE DEDICATION SERVICE TO

Recipient's Full Name *

First

Last

Recipient's Address

Same as purchaser's address

Recipient's Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Recipient's Email

Recipient's Phone

Comments

PAYMENT

The cost of one plaque is $150 CAD.

Total

$0.00

Method of Payment

Credit Card
Cheque
Other

PLEASE ENTER INFORMATION EXACTLY HOW IT IS TO APPEAR ON THE PLAQUE

PURCHASER INFORMATION FOR YOUR INVITATION TO THE DEDICATION SERVICE

SEND THE IN MEMORIAM CERTIFICATE AND INVITATION TO THE DEDICATION SERVICE TO

PAYMENT

For Cheques: