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2. If you are interested in purchasing a commemorative tree or bench, please complete and submit the following application. A representative will contact you within 5-7 business days to collect payment over the phone.

4. Applicant Information
6. First and Last Name*
8. Address*
10. City*
11. State*
12. Zip Code*
14. Phone Number*
15. Email Address*
17. Please choose which option you would like to purchase. Please note that prices are subject to change based upon market fluctuations.*

    1. Commemorative Tree $1,250
    2. Commemorative Bench $3,700
    3. Cemetery Chapel Bench & Plaque $350
    4. Serenity Garden Plaque $225
    5. Cemetery Chapel Podium Plaque $100
19. Commemorative Tree and Bench Plaque Dedication Information

    The solid bronze plaque is 4 x 6 inches and is 1/4 inch thick. It may have up to 4 lines of text with 14 characters per line. Only complete this section if you are purchasing a commemorative tree, commemorative bench, or cemetery chapel bench.

21. Line 1
23. Line 2
25. Line 3
27. Line 4
29. Serenity Garden & Cemetery Chapel Podium Plaque Information

    Serenity Garden and Cemetery Chapel Podium Plaque inscription includes name, date of birth, and date of death. Only complete this section if you are purchasing a Serenity Garden or Cemetery Chapel Podium Plaque.

31. Name
32. Date of birth
    Date of birth
33. Date of death
    Date of death
35. Will you be holding a service?*

    1. Yes
    2. No
36. If yes, please indicate the date and time of ceremony
    If yes, please indicate the date and time of ceremony Start Date

    If yes, please indicate the date and time of ceremony Start Time

    —

    If yes, please indicate the date and time of ceremony End Date

    If yes, please indicate the date and time of ceremony End Time
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field