Memorial Questionnaire
Thank you for inquiring about a memorial; it would be our privilege to help you with this process.

After you complete and submit this form we will email you a certificate for a $55 certificate that can be applied towards any memorial purchase from Barnes Memorials.  

Please fill out the following form as thoroughly as possible.  All information is preliminary to help gather ideas in this initial stages; if you do not know certain information simply leave it blank.  This form is made to help determine memorial options and what types of memorial would be suitable for your needs.  
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Email *
Name: *
Phone Number (please include area code): *
Which cemetery will your memorial be delivered to? Please include cemetery name and city. *
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