Flush Individual/Companion Memorial Order Form

Directions:

Complete form below. You will receive a rendering via email for approval, before your memorial is produced, along with an invoice. No memorial will be ordered unless paid for in full. Shipping to your cemetery is included. Once payment is received, items ship in 8-12 weeks.
Flush Markers
Memorial Size*
*Above pricing for standard grey granite.
Memorial Color*
Add 5x7 Picture to Granite
Granite Designs
Memorial Design #*
Click *Designs* above to view design book.
Name of Deceased*
Date of Birth*

MonthDayYear
Date
Date of Death*

MonthDayYear
Date
Sentiment/Memory Phrase
Please limit to 35 characters.
File Upload

Cancelof
Your Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Name of Cemetery
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Once your order has been submitted, the designer assigned to you will contact you directly with your invoice quote. Once your invoice is paid, you will receive a rendering of your memorial for your final approval.

If you have any questions or have a specific design request, please call: 877-840-2050 or email us at orders.licmemorials@gmail.com!
Phone Number
*Cemetery Approval Insurance - Choose NO if you have already talked to the cemetery and are sure that this product meets their requirements. Choose YES for us to do the work and insure you against any issues with the cemetery NO - I am responsible for product approval from my cemetery YES - 100% risk free cemetery approval insurance +$75.00*

Yes - 100% risk-free cemetery approval insurance +$75.00No - I am responsible for product approval from my cemetery
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Directions: