Field of Honor Entry | South River Electric Membership Corporation

Your Name (First and Last):

Your Email Address:

Daytime Telephone Number (please include area code):

How Many Flags Do You Wish To Display?

Amount Of Donation Per Flag Sponsorship?

At Which Office Would You Like Your Flag(s) Displayed?

Please Select If This Flag Is Donated:

In Honor

In Memory

I have more than one flag (include option listing, below)

Please List Those You Want To Honor/ Memorialize, Including Branch of Service And Theater Of Operation (If A War Veteran):

Note*

Be sure to separate individuals by (;)

How Will You Be Paying For Your Donation?

Payment Instructions

* Checks should be made out to South River EMC and mailed to:
South River EMC
Field Of Honor
PO Box 931
Dunn, NC 28335.

** Once this form has been processed, if electing to pay by credit card, South River EMC will reach out to you on the daytime telephone number provided.

*** If paying with cash, please visit one of our offices.

Do You Want To Set Your Own Flag?

Yes

Setting Your Flag

Anyone interested in setting their own flag, will have the opportunity to do so on November 4.