Your Name:                 Phone:                     

                    Your Email:             

Funeral Home you are using:              

         Funeral Director:                 Their phone number:

VERY IMPORTANT: If you want us to email a layout to you, your email may block emails from senders that are not in your address book. Please add orders@massachusettsmemorials.com to your address book, or approved email list.

MEMORIAL CARD DETAILS:

                      Text above Name: Please choose..... In Loving Memory of In Cherished Memory of In Remembrance of En Memoria de (I am entering my own in next box) (NONE wanted) or enter your own in the next box

                       Own text above Name:   

   Name of Deceased (as it will appear on card):

Date of Birth:   Date of Death: 

ORDER DETAILS:

Please select what you would like to order below, which must be confirmed by your Funeral Director.

The cards will NOT be printed until you, or your Funeral Director, have approved a layout.

Who will be approving the layout? Choose here:             please select.... Email to Funeral Home Email to both of us Email to me

       Card Choice (3-digit number):                                 Prayer/Verse Choice* :

                                                                                                              * or type 000 and type your own verse

                                                                                                            in special instructions box below

Enter any special instructions and/or your

own verse if you did not select one of ours;

             Layout Style*:               Please choose..... A layout - WITHOUT lamination (NO PHOTO, any length verse) A layout - WITH lamination (NO PHOTO, any length verse) B layout - Laminated with small photo in top corner C layout - Laminated with medium photo, medium/short verse D layout - Laminated with large photo with short verse

* Note: Cards with a photo MUST be laminated to add a 'photo-like' gloss to the image.

      Cards without a photo ('A' layout) can be either laminated or non-laminated.

                 Quantity:   Please choose..... 50 cards (minimum quantity) 75 cards 100 cards 150 cards 200 cards 250 cards 300 cards More than 300 cards        Needed by*:              

    *Orders must be placed at least 24 hours in advance if needed for the service.

 When we receive this order, we will check all of the details with your Funeral Director and

confirm the order by email (if you have entered one).  A layout will be emailed back to you

and/or your Funeral Director to check.

 Other Comments:

NOTE: Please press Submit once only, a confirmation page will appear after several

seconds for you to print o save on your computer.