Order Form for Benches  

 
Company Name: Street Address
City State
Zip Code Phone Number
   
Ship To:
 
Select Bench Color:

Everlasting Pink   Everlasting Blue

  Kershaw Pink   Salisbury Pink
  Black Veil   Everlasting Mahogany
   Other:
   
Select Bench Design: Adams  Cleary  Merriman
  Brown  Mooney
  Cremation    Other:
   
Lettering on Front Edge of Seat:
   
Lettering on Back Edge of Seat:
   
Lettering on Top of Seat:
   
Lettering on Seat Support Front:
   
Lettering on Seat Support Back:
   
Special Instructions or Design:
 
Black Litho?   Yes   No
 
Granite Pad to go Under Bench?   Yes   No
If yes, what size:
 
 
 

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