Lives Worth Remembering Order Form

You may fill out the following form to submit your order online.

All orders will be printed and shipped within 1 business day after proof approval (if requested)
for FREE 2 day delivery unless specified otherwise.

Thank you for your order.

- SHIPPING INFORMATION -

Funeral Home Name:

Contact Person's Name:

Address(no PO Boxes):

City:

State:

Zip:

Funeral Home Phone:

(

)

Evening Phone (for questions after school hours):

(

)

Email Address:

Need By Date:

- BILLING INFORMATION -
If same as billing info, leave blank

Funeral Home Name:
Billing Person’s Name:
Address:
City:	State:	Zip:

- ITEM #1

Product Type:
Quantity:
Background Theme:
Name of deceased: (as you want it to appear in the design)
Birth and Death Dates: (as you want it to appear in the design)
Poem or Prayer- INSIDE-:
INSIDE instructions or Custom Text:
Poem or Prayer- BACK-:
BACK instructions or Custom Text:

- ITEM #2
Product Type:
Quantity:
Background Theme:
Name of deceased: (as you want it to appear in the design)
Birth and Death Dates: (as you want it to appear in the design)
Poem or Prayer- INSIDE-:
INSIDE instructions or Custom Text:
Poem or Prayer- BACK-:
BACK instructions or Custom Text:

- ITEM #3
Product Type:
Quantity:
Background Theme:
Name of deceased: (as you want it to appear in the design)
Birth and Death Dates: (as you want it to appear in the design)
Poem or Prayer- INSIDE-:
INSIDE instructions or Custom Text:
Poem or Prayer- BACK-:
BACK instructions or Custom Text:

NOTE:
Photos must be scanned & emailed to info@livesworthremembering.com or dropped of at:
Gariel Screen Printing,729 Mantua Pike,West Deptford, NJ 08096.

Would you like a Proof:

NOTE: This may effect the printing and shipping dates if response is delayed

YES

Please print a copy of this order form for your records
by clicking this printer icon before you hit the Submit button.

Click here to print this order form