WPOH - Leave a Legacy

QUICK LINKS:

Directions:
1. Read over this page first
2. Fill out the form completely when you are ready.
3. After you hit the SUBMIT button at the end, a receipt will be sent to your email address. Thank you!
4. If you wish to enter a woman's life story who you have already honored, go to the bottom of the page and click on the link.

Donor Name(s)

Last Name (or Organization)

First Name

Contact/Billing Information

Name *

Last Name

First Name

Address *

Address 1

Address 2

City	State	Zipcode

Phone Number *

Email Address *

Please check this box if you wish to remain anonymous so that your
name will NOT appear in a list acknowledging donors

Where did you hear about
the Plaza? *

I wish to honor...

Honoree First Name *

Honoree Last Name *

Year of Birth

Hide Year of Birth from honoree profile.

Place of Birth

Year of death if deceased

Place of death if deceased

Relationship to donor (if relevant)

Email address for notification

Areas of Achievement
Please check all that apply. The categories listed below reflect a broad understanding of each activity, including both volunteer and paid. They also include all levels of involvement; for example, 'Business' includes both employee and employer, 'Health Care' includes everything from physicians to the lab technician.
	Activism	Domestic Work	Media	Social Service
	Adventure	Education	Military	Technology
	Agriculture	Health/Medicine	Philanthropy	Volunteerism
	Architecture	Higher Education	Politics	Other:
	Aviation	Home Making	Ranching
	Arts	Law	Religion
	Business	Library Science	Sales/Retail
	Clerical	Literature	Science
	Community Building	Manufacturing	Self-Employed

How you wish to comemorate your Honoree:

More about these options

Amount: $

How your Inscription will Appear

* In the box below, enter exactly how you would like your inscription to appear on the commemorative item. For any questions on the number of characters permitted on your item, please call 520-626-0656.

Her Story

* In approximately 500 words, tell the story of the woman you are honoring - her life, her accomplishments - and why you wish to honor her.

If you need help, feel free to read other bios on this website or call 520-626-0656. This biographical narrative you compose will appear on this website when this form has been reviewed and entered by the committee for other people to read about her. If you need more time, you can submit your bio later by mail or email.

I will send my bio later by mail or email.

Information Sources

* If you have used special resources such as library texts, recordings or the internet to compose the Story above, please list those important sources here.

Photo

	I do not have a photo available

	I have a photo to send in

	I have a digital photo:

Arranging Payment

	I will send in this form accompanied by my check paid in full. (Check made payable to the UA Foundation/Women's Plaza)

	I will call my credit card number in over the phone. (Phone number to call when done is: 520-626-0656)

	I will email a request for someone to call me back so that I can make arrangements for payment right away.

	I will pay online by credit card. (To pay online, please use the provided link on the confirmation page.)

Check all of your information!

Please proof all of the information above to check for accuracy.
If you are satisfied, hit the SUBMIT button. You will get a receipt in your
email. Please print out and mail a copy with your check or keep for
your records. We will contact you very soon! Thank you so much
for your support!

Thank you for honoring a special woman in your life.

The Women's Plaza of Honor reserves the right to edit all submissions and to revise or refuse any submission which is deemed objectionable in subject matter or phraseology, in our sole discretion. Submitter assumes all responsibility for statements, and the veracity thereof, contained in submissions published by the Women's Plaza of Honor.

If you wish to submit the life story of a woman you have already honored at a previous date, please click here.