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Casket Order Form

Quantity *

Shipping Address

Name *

Address *

City *

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Zip Code *

Is this address a mortuary or funeral home?

Receiving Funeral Information (If available)

Contact Name

Phone

Fax

Desired date and time of the funeral viewing/services (Not required to order casket)

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Time

Buyer Information

Title

First Name *

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County

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Country *

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Deceased Person Information

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Weight

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Order Summary

Natural or Stained Raised Flat Top Poplar OR Pine Casket

$1,499.99 ~~$3,995.99~~

Natural or Stained Raised Flat Top Poplar OR Pine Casket x 1 $1,499.99

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Casket Order Form

Shipping Address

Receiving Funeral Information (If available)

Buyer Information

Shipping Options

Deceased Person Information

Additional Information

How did you hear about us?

Order Summary

Natural or Stained Raised Flat Top Poplar OR Pine Casket

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Casket Order Form

Shipping Address

Receiving Funeral Information (If available)

Buyer Information

Shipping Options

Deceased Person Information

Additional Information

How did you hear about us?

Order Summary

Natural or Stained Raised Flat Top Poplar OR Pine Casket