Order Form

Your Name*

Funeral Home*

PO/Case #*

Email*

Phone*

Urn Details

Start of Urn Order #1

Date Needed By*

Urn #

ex. "D-309"

Urn Description

ex. "Covered Bridge"

Urn Quantity*

Please enter a number greater than or equal to 1.

Base

Wood

Please check your desired urn for available wood choices.

Photo Upload

Accepted file types: jpg, gif, png, pdf, jpeg, bmp, Max. file size: 2 MB.

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Personalization with Text, Urn 1

Date of Birth

Date of Death

Endearment, Line 1

Endearment, Line 2

Endearment, Line 3

Endearment, Line 4

Font Style

View font samples

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End of Urn 1 Personalization with Text

Additional notes

Urn 2 Details

(Hey Doug, once the order form is completely dialed in the way you want it, I'll create the ability to add more urns to the order; the "Urn Details" fields above will be repeated. - Rochelle)

Phone

This field is for validation purposes and should be left unchanged.

Creating a unique and lasting memory for loved ones.