Media Purchase

							                                        Memorial Media Purchase Order


 Select Cemetery Location of Kiosk Memorial: Holy Rood ____ Queen of All Saints ___ Holy Sepulcbre ____

Name of Customer: __________________________________________________

Address: ___________________________________________________________

Telephone: ______________________________ Date: ______________________

I HEREBY AUTHORIZE THE CATHOLIC CEMETERIES TO
ENTER THE MUL TIMEDIA MEMORIAL ORDER FOR

               DECEASED’S NAME: ____________________________________

               BURIAL LOCATION: ____________________________________

I UNDERSTAND THAT THE TEXT PRODUCED IN ACCORDANCE WITH THIS ORDER IS FINAL. I
HAVE CHECKED IT CAREFULL Y AND CORRECTION OF ANY ERRORS IN THIS ORDER IS AT
MY EXPENSE.
                               SIGNATURE: ___________________________________________
Please note:
        Base price of $310 includes picture and 175 words of text. Each additional page, which may include
other photos & a family tree or up to 350 words of text, is $125. CD (Disk) with full copy will be mailed to you
for viewing on your home computer. A standard memorial is one (1) double page: a picture on the inside left
page with the name of the deceased along with the year of birth and year of death, and personal text of up to
175 words on the inside right page. Please provide us with a clear picture (portrait) in black & white or color
no larger than 8x10 inches and not smaller than a passport size. A 5 x 7inch photo is the ideal size. IN THE
UNLIKELY EVENT THAT THERE IS EITHER DAMAGE TO OR LOSS OF THE SUPPLIED PICTURE,
CATHOLIC CEMETERIES' LIABlLI1Y WILL BE LIMITED TO THE COST OF A REPLACEMENT
PRINT FROM A SUPPLIED NEGATIVE
        For a more personalized memorial, you may provide a nice hand-written document of no more than 100
words to be electronically reproduced as your memorial. Opening screen picture must be of deceased family
member only, and must be portrait type or similar. Many pictures may be computer enhanced to obtain this effect at
a small additional cost. Pictures that may appear on subsequent pages may include other family members, wedding
photos, and other pictures in less formal setting. Cemetery personnel will discuss the appropriateness of these photos
with you. The memorial can be viewed whenever you visit our cemetery and it will also be automatically displayed
at the kiosk every year on the anniversary of the date of death and the date of birth of your loved one. A map of the
cemetery highlighting the section location of interment is also provided. Please complete and sign the attached
purchase order and mail or bring it to our office with text, picture and check as payment (Bank Debit, Visa,
Mastercard, and Discover accepted too). You will be advised when memorial and CD are complete. Note: Memorial
is guaranteed for a 10-year period from date of installation in the system. Renewal thereafter subject to rules and
prices then in effect. The Catholic Cemeteries reserves the right to upgrade or modernize the system as technology
dictates. 9.1.2009




      Catholic Cemeteries - of the Diocese of Rockville Centre P.O. Box 182, Westbury, NY 11590-0182
                                            Memorial Media Purchase Order

                                          Guidelines to Write Your Memorial

There is no right or wrong way to write a memorial for a loved one. It could include biographical information an
obituary, personal reflections, favorite sayings or poems. It’s a great place to place images of the items that should
not or could not be placed at the grave, crypt, or niche. It’s also a great place to include the personal sayings and
slogans that do not meet the cemeteries regulations for remembrance on the family monument or crypt cover.

Checklist of Items You May Wish to Include:

Date of birth
Town, Country of Birth,
Date of Death
Town Country of Death
Family Tree Information
Spouse, Children, Parents, Grandparents, Grandchildren
Childhood (locations, memorable events)
Education (institutions, degrees, honors)
Wedding (location date)
Special Interest (favorite hobbies, games, sports, music
team logos)
Career (places worked, positions, achievements)
Military Experience (years, medals, honors)
Unique Talents, Accomplishments
Life’s Memorable Events, Closing Remarks (saying,
poem)




        More than one memorial may be purchased by different family members who wish to express their personal sentiments.




   Please compose your memorial by using the form on the reverse of this sheet, attaching additional sheets if necessary.




      Catholic Cemeteries - of the Diocese of Rockville Centre P.O. Box 182, Westbury, NY 11590-0182
Memorial Media Purchase Order
                                  PLEASE PRINT CLEARLY OR TYPE
DECEASED’S FULL NAME: ________________________________________________________________


                     (using either middle initial or middle name with Maiden name mentioned if appropriate)

Date of Birth: _________________________ Date of Death: ____________________________________

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___

__________________________________________________________________________________ Word Count ___


                                           Use additional sheets if necessary



     Catholic Cemeteries - of the Diocese of Rockville Centre P.O. Box 182, Westbury, NY 11590-0182
              Kiosk Memorials
                Cemetery of the Holy Rood
                       PO Box 182
                  Westbury, NY 11590
                     (516) 334-7990


               Queen of All Saints Cemetery
                   115 Wheeler Road
                 Central Islip, NY 11722
                     (631) 234-8297


                 Holy Sepulchre Cemetery
                      3442 Route 112
                    Coram, NY 11727
                      (631) 732-3460



        THE GREAT STORY OF
         A LOVED ONE’S LIFE
             WAS MEANT
            TO BE TOLD.
          SO THAT FUTURE
         GENERATIONS WILL
               KNOW.




                      (516) 334-7990

Catholic Cemeteries - of the Diocese of Rockville Centre P.O.
           Box 182, Westbury, NY 11590-0182
         Kiosk Memorials
   What is a Kiosk memorial?
       At each diocesan cemetery there is a self-serve
        computer with a touch screen called a Kiosk.
          This is used to look up a deceased’ burial
            location and the digital maps assists
     family and other visitors with locating burial sites.

        Often this can be the first form of contact
           with a family member conducting
           genealogical research on families.

        Catholic Cemeteries has the ability to scan
                a photo of the deceased and
            create a few pages for a biography
                     about a loved one.
              It’s accessible to all regardless
                  of the day of visitation.
               How does it work?
     Once the screen is touched a visitor types in the
            deceased’s last name and selects
         the name from an alphabetical listing.
     The visitor is presented with the grave location
           and can touch the tab called image
      where they can see the image of the deceased
                then read and remember.

      Some memorials are personalized memorials
        with a nice hand-written document and
          others have pictures that appear on
  subsequent pages that include other family members,
              wedding photos, and other
            pictures in less formal settings.

    All memorials can be viewed whenever you visit
     our cemetery and it will also be automatically
         displayed at the kiosk every year on the
           anniversary of the date of death and
            the date of birth of your loved one.
          Some memorials include biographical
     information an obituary, personal reflections,
             favorite sayings or poems others
       place images of the items that should not or
    could not be placed at the grave, crypt, or niche.
     Some memorials include the personal sayings
               and slogans that do not meet
          the cemeteries of the Diocese of Rockville Centre P.O.
Catholic Cemeteries - regulations for remembrance
            on the family monument or crypt cover.
              Box 182, Westbury, NY 11590-0182