ORDER FORM
| NAME ON MEMORIAL |
CEMETERY |
LOCATION OR YEAR OF DEATH |
DESIGN # |
PRICE |
VISA OR M\C #_______________________________
EXP. DATE___________________________________
CARD HOLDER NAME:___________________________________
| SUBTOTAL | |
| TAX (6%) | |
| DELIVERY TO CEMETERY($10.00 PER CEMETERY) | |
| TAGS ($5.00 FOR GRANDLAWN) | |
| TOTAL |
MAIL THIS TO:
Simpson Granite
23466 GRAND RIVER, DETROIT, MI. 48219
OR CALL: (313) 531-0378
FREE DELIVERY TO GRAND LAWN CEMETERY