Flush/ Bevel Memorial Order Form

Slants and Upright Memorial Designs
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.
Memorial Size *
Memorial Color *
Memorial Design *
Name of Deceased *
Date of Birth *

Month Day Year
Date
Date of Death *

Month Day Year
Date
Sentiment/Memory Phrase
Please limit to 35 characters.
Your Name *
Address *

Street Address

Street Address Line 2

City State / Province

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

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
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 +$75.00 No - I am responsible for product approval from my cemetery
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!
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