Placement Plans

Yes, I’d like to order the Floral Placement Service Plan Below.

Plan #1:       Option “A”                               Option “B”

Plan #2:       Option “A”                               Option “B”

Plan #3:       Option “A”                               Option “B”

Name of Deceased                                                             

Name of Cemetery                                                              

                    Cemetery                                 Mausoleum

Lot #                       Section                         Space                                      

Simply choose placement dates you prefer from the following            suggested list:

        Christmas                                             Mother’s Day

        New Year’s Day                                  Father’s Day

        Easter                                                   Memorial Day 

        Thanksgiving                                         Hanukkah

        Birthday (Give Date)                                        

        Anniversary (Give Date)                                  

        Other (Give Date)                                            

Ordered By:

Your Name:                                                            

Address:                                                                             

City                      State                     Zip                

Telephone (       )                             

All plans are payable in advance by check or credit card.  No  placement will be made until payment has been received

        I have enclosed a check for $               

        Please Charge to my

                    Mastercard                               Visa

My Credit Card Number is:                                     

The expiration date is:                                                          

Signature: