Order Online

Please select your item and fill out the boxes below with your inscription.

Please remember these simple guidelines:

  • Items may be personalized up to 3 lines with up to
    20 characters per line.
  • Please make sure your order form is accurate. Items are
    etched directly from the information submitted.

Please Choose From The Options Below
Line 1
Line 2
Line 3




You can also order your Wall Plaque, Paving Stone or Table & Chair Set by printing this form and sending your check or money order to:

HealthAlliance Guild
c/o Development Office
60 Hospital Road
Leominster, MA 01453