Memorial Insert Panel Order Form
Your Name :
Shipping Address :
Zip Code :
Daytime Phone :
Evening Phone :
E-mail Address :
Date Need by :
Sending Photo :
Scanning and e-mailing photo
Digital photo by e-mail
Sending photo by regular mail
Sending photo by overnight delivery
Sending photo by 2 day delivery
Shipping Options :
Shipping by Priority Mail (2 to 3 days) By Quote
Overnight Delivery- By Quote
Overnight Saturday Delivery- By quote.
Name of Loved One
as you want it on Panel :
Date Born :
Date Died :
Text Above Name :
In Loving Memory of
In Loving Remembrance of
In Cherished Memory of
En Memoria de
Other-Entered in text box
Other Text Above Name:
*Exact Panel Size:
Sized to Fit $100.
Panel Design Number :
Panel Quantity :
Special instructions and custom prayer, poem or text here.
You will NOT be asked to pay when you submit this order form.
We will e-mail you a confirmation with the total cost, including shipping costs and secure payment instructions. Directions on how to submit your photo will also be included.
*Ask your Funeral Director for the dimensions of the top interior panel of the casket you selected. A design proof of your poster will be e-mailed to you for your approval before your order is printed.
You may send your digital photo or scanned image to:
we will be watching for it. Please be sure to send your photo at the largest possible size. Do not worry about cropping or removing others from the photo we will do that for you.
By clicking "Place Order Now" button you are agreeing to the
Terms and Conditions
of Memorial Prayer Cards.
Massachusetts state residents add 6.25% sales tax
Please be sure to check your e-mail after you place an order. We will e-mail you usually within hours of placing an order (depending on the time of day/night). Always within 24 hours of placing an order.
If you are using any e-mail spam blockers it may be necessary to turn them off.
Memorial Prayer Cards accepts all major credit cards and debit cards. We process our credit and debit cards
through PayPal's secure server. Once you place an order you will receive a Memorial Prayer Card invoice
from PayPal requesting payment. You do not need a PayPal account in order to use PayPal.