Please complete and submit the order form below to begin your order (or use our PDF form, Excel Form, or try our new Marker Designer):

Leave this field blank if you can see this:
Date:     P.O. Order #:
Customer Phone:   Fax Number:   Email:
INVOICE TO:   SHIP TO:
 
INSCRIPTION: WITHIN SPACE BELOW TYPE ALL DETAILS, NAME, DATE OF BIRTH, DATE OF DEATH, SPECIAL INSCRIPTION, POSITION OF EMBLEM, ETC.
Emblems
Number Name
I DO I DO NOT GIVE PERMISSION FOR FAMILY BRONZE TO ADJUST ORDER FOR AESTHETIC APPEARANCE, LETTER SIZES AND EMBLEM SIZES. MINOR CHANGES ARE SOMETIMES REQUIRED.
Size Border Design Letters
  24x12  VA MATCH   ROSE   FLAT (Wider, Glossier)
  24x14   WOOD   LONG-STEM ROSE   OVAL (Thinner, Less Glossy)
  16x24   ROCK   DOGWOOD
  44x14     VA CUSTOM
  TWO 24x12     WHEAT
  7" ROUND CREMATION
           -Single Line Border		     LILY
  11x14 CREMATION
             - Single Line Border		     ROSE/DOGWOOD
        (16x24 WOOD BORDER ONLY)
  24x14 CREMATION     OTHER 
  OTHER     
   
 
VASE/RING
TYPE OF VASE RING QUANTITY
 NO VASE  
  PLAIN   ANGEL*
  CROSS   ROSE*
 NO RING  
  PLAIN   TOGETHER FOREVER*
  STAR   PERSONALIZED CUSTOM
 
GOV'T MATCH SCROLL   
    DATE
 
*Premium vase add $45
 
SPECIAL INSTRUCTIONS:
 
Before you submit your order please print this page for your records.

You will receive an email confirmation that we have received your order