Cougar Memorial

Cougar Family Memorial Park

Conant High School has created a memorial park for our fallen Cougars. A minimum donation of $100.00 to Cougars in Need will allow you to memorialize a past Cougar. A bronze plate with the name of the fallen Cougar will be created and permanently fastened to a brick within the pillars of our park which is located in the front of the school between doors 1 and 3.

	Examples (1/8" thick x 2" x 7") Please complete this form to the best of your knowledge. Make check payable to “Cougars in Need”. Orders will be placed twice a year and added to our park.

	Fallen Cougar to be Memorialized

	Name to be Memorialized:*

	Contributor Information

	Name:*

	Email Address:

	Phone Number:*

	Please fill out the appropriate box below.

	Military Information

	Fallen in Military Service
	Fallen in Military Service Yes No

	Example of fallen in service military plate:

	Example of military plate:

	Student Information

	Student
	Student Yes No

	If known, please complete the following:

	Class of:

	Maiden Name:

	Birth Date:

	Example of student plate:

	Support Staff Information

	Support Staff
	Support Staff Yes No

	Department:

	Example of support staff plate:

	Teacher / Administrator Information

	Teacher / Administrator
	Teacher / Administrator Yes No

	Department:

	Example of teacher / administrator plate: