Application Form

If you are interested in purchasing and donating an Ad Astra Stone, you may print out your own forms here, in Adobe PDF format. Adobe Acrobat Reader software is required to view them. If you require Adobe Acrobat, you can download it free from www.adobe.com.

Complete both pages and sign on page 1 before mailing. Please include your cheque or credit card information.

Stones purchased between July 15, 2016 and July 15, 2017 will be included in the 2017 dedication ceremony.

Ad Astra Stone Application English	Ad Astra Stone Application French