1. Title of Marker: Required 2. Topic of Marker: Select all that apply. Historic Events Significant Person(s) Prehistory or Archeology Cultural Heritage Contributes to State History 3. Location of Proposed Marker: Include a written description and attach map separately indicating the proposed location. Description File Upload Total file size for all files cannot exceed 17MB. (pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt) Property Name (if applicable) Address Required City Required County Required State Required Zip Required GPS coordinates (if known): Latitude: Longitude: 4. Property Owner of the land in which marker is to be erected. Name Required Organization Address Required City Required State Required Zip Required Phone Required Email Address Required 5. Type of Marker:Required: Choose One Single Post Marker30 X 42 inches. Space for about 80 words. Cost: $2,300.00 (cost includes post and shipping) 2 Post Marker5 X 6 feet. Space for about 180 words. Cost: $6,000.00 (cost includes posts and shipping) Table Style Marker 3 X 6 feet. Space for about 170 words. Cost: $3,500 (cost includes shipping but does not include mounting or base) 6. Marker Text: Provide below or on a separate sheet of paper a draft of a suggested marker text. The text must be historically accurate, informative and concise. All texts provided are subject to edits to ensure authenticity and accuracy. File Upload Total file size for all files cannot exceed 17MB. (pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt) 7. Sources and Bibliography: Provide below or on a separate sheet of paper all publications, sources and references used. File Upload Total file size for all files cannot exceed 17MB. (pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt) 8. Shipping Address: A commercial address (no P.O. Boxes) with the name of an office or business open between 8 am – 5 pm, Monday through Friday. It is the responsibility of the receiver at the shipping address to inspect the marker prior to accepting delivery. Inspection and shipping policy and requirements will be provided. Organization/business name Required Contact name Required Street Address Required City Required State Required Zip Code Required Phone Required Email Address Required Security Authentication Required For security purposes, you must complete the recaptcha before submitting the comment form. Submit Reset
