Please enable JavaScript in your browser to complete this form.DatePurchaserAddressCity, State, ZipPhoneEmailYou are here by authorized to manufacture and deliver toGraveLotBlockInCemeteryCityStateDuring/Year (or reasonable time thereafter)LongitudeLatitudeSexton/CaretakerCellHome/WorkCheck All That ApplyMonumentSlantBevelMarkerOtherBronzeBronze on GraniteLugCeramic Photo __ SizeVase ___ Type__ ColorGround ___ SizeMaterialDesignSize/DescriptionSize/DescriptionType of lettering family name:Family Name ___ SidesCarve Design ___ SidesType of lettering inscriptions:Inscriptions ___ SidesBurial TypeCremationFull BodyNoneUpload Image Click or drag a file to this area to upload. Future Lettering Not Included$ Memorial$ Lettering$ Foundation$Desc$ DescSub-TotalSales Tax %$ Cemetery Fee$ Total$ Deposit$ Balance DueDrawing Approval RequiredNoYes (Email Drawing)Yes (Mail Drawing)Select Correct DirectionPlace OnEastWestNorthSouthEnd of graveStone FaceEastWestNorthSouthWith Man/Lady to the EastWestNorthSouthWhite EnvelopeYesNoGrave LayoutSingle GraveCenter on 2 GravesCenter on Family LotOtherSpecial InstructionCementYesNoFlushYesNoFoundations ByDMCCemeteryOtherInstallation ByDMCCemeteryOtherMargin SizeHeight FrontHeight BackSignaturesPurchaserClear SignatureDakota Monument RepClear SignatureSend Photo To Customer MailEmailSubmit
