Photo order form

Print out this form and then

You may fax , e-mail us, or phone in your order , or ask us a question!

Bench stones, Custom engraved stones, Personalized stones. Please follow the sample guide lines shown on line. All stones have limitations
Line 1
Line 2
Line 3
Line 4
Line 5
Line 6
Product
Size
Item Description
Item Number
Other
Price
         
         
         
Call us for shipping cost and or expedited shipping cost toll free 1-800-260-2201
  
New York State residents add 8% Sales Tax!
 
Total Amount:
  
Billing
Shipping Product is (shipped signature required
with FedEx Overnight.)
Date
Name
Name
Attn:
Address

Address

City
City
State ______________________Zip ________
State _____________________Zip: __________
Daytime Phone

Phone
E-mail
Fax Number
Check...... (or).... Money Order...... Visa ..Master.. Card ....American Express .........Discover
Name on Card

Card Number________ ____________________________CCV _________ Expiration Date __________
Signature

I the undersigned understand the total amount is for the item ordered and excludes any cemetery fees.
I also understand the grave marker will be laid out for best appearance. By signing this document I agree to the terms and conditions on the Starlight Memorials web site.

Starlight Memorials.. 42 Kukuk Lane ..Kingston.. N.Y. 12401

Memorial Products, Grave Markers, Cremation urns , Home & garden Products

Toll free 1-800-260-2201------Fax Number 1-845-382-1629