Monument Placement Request Form
Kanarraville Town Cemetery
Contact Information
Requestor, Monument Company, and Monument Purchaser
Requestor's Name:
*
First and Last Name of person completing this form
Requestor's Phone Number:
*
Please enter a valid phone number.
Requestor's Email
*
example@example.com
Monument Company Name:
*
Monument Company Phone Number:
Please enter a valid phone number. Leave blank if same as requestor.
Monument Company Email
example@example.com - Leave blank if same as requestor
Full Name of Monument Purchaser:
*
Name of the person who ordered the monument
Phone Number of Monument Purchaser:
*
Please enter a valid phone number.
Email of Monument Purchaser:
example@example.com
Placement Date and Time
Select the Desired Placement Date and Time
*
Monument Information and Dimensions
Full Name on Monument
*
First Name
Middle Name
Last Name
Full Name on Monument (Optional - Second name on monument)
First Name
Middle Name
Last Name
Full Name on Monument (Optional - Third name on monument)
First Name
Middle Name
Last Name
Type of Monument (select all that apply)
*
Upright
Slope
Flat
Bench
Double
Single
Urn Plaque
Other
Monument Length
*
Measurement in Inches
Monument Width
*
Measurement in Inches
Monument Height
*
Measurement in Inches
Monument Foundation Length
*
Measurement in Inches
Monument Foundation Width
*
Measurement in Inches
Monument Foundation Depth/Height
*
Measurement in Inches
What's Next?
Kanarraville's Cemetery Manager will mark the monument location and respond to the Requestor within two to three business days. If a more urgent response is needed, please call or text Michael Humes at (435)704-1215. For all other inquiries, please email Michael Humes at cemetery@kanarraville.org
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