JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Online Memorial Order Form
Our expert design consultants will create a proof ( what the finished memorial will look like) from the information you provide and email the proof to you. If you would like to speak with someone directly please call
(204)334-4721.
To view our catalog click this link:
https://rb.gy/rvh4op
***5% OFF ONLINE ORDERS***
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Phone number
*
Your answer
Your Name:
*
Your answer
Your Address:
*
Your answer
Cemetery / location where the memorial will be placed:
*
Your answer
Name(s) on memorial:
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Date of Death:
*
MM
/
DD
/
YYYY
Is there a stone in our catalog you are wanting? ( Name on stone in catalog):
Your answer
What type of memorial are you wanting?
*
Upright Memorial
Flat Marker
Pillow Marker
Custom Shaped Memorial
Memorial Bench
Gold Leaf
Laser Etching
Other:
Date of Birth (if 2nd person):
MM
/
DD
/
YYYY
Date of Death (if 2nd person):
MM
/
DD
/
YYYY
What would you like the memorial to look like? Consider color, shape, wording(Epitaph), images, and upgrades like gold leaf, laser etching, color paint, and ceramic portraits. Please provide as much detail as possible.
*
Your answer
We will be in contact with you to discuss anymore details.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
