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!

*Lettering and Dates (Please print clearly) Pet & People Markers
Left & Top Side
Right & Bottom Side
Family Sir Name
Name
Name
Date of Birth
Date of Birth
Date of Death
Date of Death

Name and dates are included in our price. Companion memorials are laid out as if you are standing at the end of the grave looking up at the top (Please check with the cemetery on burial side). Individual memorials please use the left side.

Special Instructions | Additional lettering. * First 25 letters are free of charge. Additional letters are $2.97 each
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Product if its a cast plaque (Stake type) (Mounting method) Put in description column
Size
Item Description
Vase
Other
Granite Color
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 grave marker 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