Memorial Name: (shown at top of page)
Memorial Colour: (if applicable)
Cemetery / Churchyard:
Name on Headstone:
Date of Birth:
Date of Death:
Proposed Inscription: (please include full details here)
* Customer Name:
* Customer Telephone Number:
* Customer Email Address:
Any further inscriptions/names in the future?
Flower Facility Required?
Right Hand Side (standard position)
Left Hand Side
Two (each side + £35)
Would you like a free drawing of the proposed memorial posted or emailed to you?
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Any further inscriptions in future?
Would you like a free drawing of yourmemorial posted to you?
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