P.O. Box 942
Oak Grove, MO 64075-0942
www.oakgrovehistory.com

Oak Grove Historical Society is undertaking an effort to commemorate and honor the early residents of Oak Grove and those who made their homes in the community. This effort is part of the historical society's plan to eventually establish a building to house the historical memorabilia of our community.

As a part of this endeavor the group is encouraging people to purchase commemorative plaques for their family members. These plaques will be displayed temporarily in the lower level of the Davis building, where the historical society meets, until we are able to move to a permanent location.

A minimum contribution of $50.00 for each ancestor's plaque is requested.

If you would like to purchase a commemorative plaque, please fill out the form below and mail to:
Oak Grove Historical Society, P.O. Box 942, Oak Grove, MO 64075

Historical Society

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Name of Ancestor:

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	First		Middle		Last

Date of Birth:

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Date of Death:

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Name of Ancestor's Spouse:

__________________________________________________________________________

	First		Middle		Last

Date of Birth:

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Date of Death:

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* For Additional Ancestors, Attach Separate Sheet.