ORDER FORM FOR WINTER GRAVE BLANKET - DOC by qiant230

VIEWS: 15 PAGES: 1

									                                              2009 ORDER FORM FOR
                                                  WINTER GRAVE
                                                    BLANKETS

                                             The Grave Blankets are priced at
                                             $50.00 each, this price includes the
                                             7% Indiana Sales Tax.




PLEASE PRINT FULL NAME OF DECEASED                          AMOUNT

__________________________________________________________________    $_________
__________________________________________________________________    $_________
__________________________________________________________________    $_________
__________________________________________________________________    $_________
TOTAL AMOUNT OF ORDER………………………………………………….                             $_________

METHOD OF PAYMENT:

_______ Enclosed is my check or money order payable to:
        TIPPECANOE MEMORY GARDENS for total amount.

_______ Credit Card: VISA CARD    #____________________________________________
                     MASTERCARD #____________________________________________
                     NAME ON CARD ____________________________________________
                     EXPIRATION DATE__________________________________________

SIGNED_______________________________________________________________________
ADDRESS _____________________________________________________________________
_______________________________________________________________________________
PHONE NUMBER_______________________________________________________________
E-MAIL ADDRESS ______________________________________________________________


             Please check here if you’d like information about our
     Memorial Trees           Memorial Benches              Memorial Brick


 Tippecanoe Memory Gardens, Inc., 1718 W. 350 N., WL 47906 765-463-2383
            www.tmgardens.com          office@tmgardens.com

								
To top