Marker Approval Form

Please provide the following information to request marker approval and foundation installation.

All fields are required.

Purchaser Information

Name

Address

City

State

ZIP Code

Phone Number

Email

Marker Information

Layout required before approval.

Family Lot
 Yes No

Marker Location
Include block, lot, gravespace(s)

Marking the Grave of:

Date of Death/Pre-Need

Marker Style

Separate Base
 Yes No

Material
 Granite Bronze

If Upright Monument, will reverse side be used for other graves?
 Yes No NA

Marker Base Size

Marker Height

Number of Vases

Size and Description of Vase(s)
Attach to marker or foundation? Ground vase? Allow for core hole in foundation?

If foundation:
 Side Front Center NA

Length of concrete pad
Determined by lot size (length of base + vases + 4 inches)

Foundation Charges
Minimum charge $100.00 plus taxes

Monument Company/Vendor Information

Company Name

Contact person

Email

Address

City

State

ZIP Code

Phone Number

Date of Sale

Date Desired in Cemetery