PRECIOUS PRESERVE MEMORIES CUSTOM ORDER FORM

PRECIOUS PRESERVE MEMORIES CUSTOM ORDER FORM

Preserving Yesterday. Cherishing Forever.
CUSTOMER INFORMATION
Customer Name:
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
ORDER DETAILS
Collection Type (Check One)
PRODUCT SELECTION
Other
PERSONALIZATION DETAILS
Name(s) to Include:
Date(s) to Include:
Quote, Message, or Memorial Wording:
FLOWER INFORMATION
Will flowers be provided?
Special Instructions:
PHOTO INFORMATION
Photo Included?
Number of Photos:

Other
Photo Description:
ADD-ONS
PAYMENT INFORMATION
Subtotal:
Add-Ons:
Sales Tax(7%):
Total Due:
Deposit Paid:
Balance Due:
Payment Method:
CUSTOMER AGREEMENT
I understand that all keepsakes are custom-made and handcrafted. Due to the personalized nature of each order, refunds may not be available once production has begun.
Signature
Date

MonthDayYear
Date
Should be Empty:

CUSTOMER INFORMATION