Vault/Service Order Form

Order Form

Ordered By (Full Name)

Email (Used for Email Order Confirmation)

Funeral Home

Phone Number

Cemetery

Location of Cemetery (City)

Name of Deceased (Full Name)

Deceased Year of Birth

Date of Service

Type of Service

Time of Service

Anticipated Time of Burial

Type of Graveside Service *

Full Equipment

Set & Seal

Delivery Only (No Equipment/Lowering Device)

Hearse Only

Other (Request in Comments)

Type of Vault *

Tex

Concrete Box (No Color/Emblem)

Sentry

Honor

Trinity

Parian

Aegean Elite

Aegean (White)

Aegean (Black)

Aegean (Rose)

Healing Tree

Regal Stainless

Regal Copper

Regal Bronze

Aegean Elite (Stainless)

Aegean Elite (Copper)

Vault Color

Emblem

Comments

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