DUP Headstone Medallion Order Request

Honor the pioneer heritage of your loved one who was a Member of the International Society Daughters of Utah Pioneers. A medallion is available to be placed on the headstone of a deceased Member. The medallion is an everlasting memorial sculpted and finished into the antique bronze medallion pictured on this page. It is available in (4) four-inch, (3) three-inch, and (2) two-inch sizes.

Medallions are purchased from the ISDUP Business Office at the Pioneer Memorial Museum. This form may be filled out with all the information requested or you can optionally download and mail or email a scanned copy to . Check, cash, credit card or Venmo are accepted methods of payment. DO NOT submit this form without also including the DUP membership number or without also placing your order.

    DUP Headstone Medallion Order Request

    Daughters of Utah Pioneers 6-digit membership number:

    If the number is not known, you can contact the DUP Business Office at 801-532-6479 ext. 200

    Medallion Ordered:

    Information from person placing order:

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