Contact Us
 

For your convenience you can order in one of 3 ways.

  1. By calling us Toll Free at: 1-866-494-1774
  2. By downloading and faxing our order form here: orderform.pdf
  3. By completing our easy to use form below, we will then contact you to complete the order.

* Denotes a required field

Most orders ship in 24 hours however, some conditions may apply.

 
If you require pricing information please visit our pricing page

A. Funeral Home Information
Company Name:*
 Contact Person:*
E-mail address:
Fax number:
Phone number:* Date:
B. Billing and Shipping Information
Name:*
 Company:*
Address:*
City:*
Province:* Postal Code:*
   
Description
Item #
Quantity
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Special Instructions:
Name of Deceased:*
Date of Birth:* Date of Passing:*
   
Remember:
To ensure a proper fit we recommend you measure the interior casket lid opening in inches. Then fill in the dimensions in the boxes provided. We also include panel mounting pins with every panel purchased.
Width in Inches: Height in Inches:
Height and Width Measurements

Additional Comments:


 
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