Custom Candle Order Form

Custom Candle Order Form

☆ Please start by choosing your candle type below. The form will guide you step-by-step.☆
Which type of memorial candle would you like?
Candle Details
Select Your Candle Design
Refer to chart above
Name on Candle
Write the name exactly as you'd like it to appear
Sunrise/Sunset Dates
Optional — for example: 05/12/1965-09/08/2024
Quantity
Upload Photo

Please provide the picture you'd like to be used for the candle
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Message for Back of Candle
Optional — include a short message, poem, or verse for the back
Special Requests/Notes
Optional — Share any font preferences, background ideas (for photo), designs, or special requests
Customer Information
Customer's Name

First NameLast Name
Phone Number
Optional — only used if we need an immediate responseFormat: (000) 000-0000.
Email Address
example@example.com
Delivery/Pickup Information
Order Fulfillment
Please select how you'd like to receive your candle
Delivery Address

Street Address

Street Address Line 2

CityState

Zip Code
We'll calculate the shipping cost after your order is packed and weighed.

You'll receive an email with the final shipping fee and a payment link before we send your order.
Payment Method
For reference only — payment will be arranged after your order is reviewed
How did you find us?
Pickup/Local Delivery *If placing more than one order, select date/time on one form only*
Should be Empty:

Candle Details