Argus Institute for Families and Veterinary Medicine

Memorial Plaque Form

Honor your beloved companion animal by adding a tribute to one of three memorial plaques on display at the Colorado State University Veterinary Teaching Hospital. These memorials serve as a lasting testimonial to the unconditional love, joy, spirit, and beauty that companion animals bring to our lives and hearts. For a $100 or more donation to the Argus Institute for Families and Veterinary Medicine, a name plate will be engraved in the following format:

Pet's Name
Date of Birth - Date of Death
Tribute

Please print (maximum of 30 characters per line, including spaces).

Pet's Name ________________________________________________

Date of Birth Date of Death ____________________________________

Tribute ____________________________________________________

Circle one: Canine Feline Equine

Male Female

Please provide owner information so we may send an acknowledgment.

Name ____________________________________________________

Address __________________________________________________

City ______________________________________________________

State Zip _________________________________________________

Please print and complete this form. Return with payment to:

Argus Institute for Families and Veterinary Medicine
Colorado State University
James L. Voss Veterinary Teaching Hospital
300 West Drake Road
Fort Collins, CO 80523

Contact the Argus office at (970) 297-4143 if you have questions or need additional information. Thank you for your generosity.