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INFORMATION AND
ORDER FORM FOR PET MEMORIAL SHADOW BOX
Click here to Email us with any questions
Please fill out this form and then click the "Submit" button found at the end of the form. Receipt of your submission will be acknowledged.
*
Is a required entry

*1. Your First and Last Name:

*2. What Is Your Email Address:

*3. Confirm Your Email Address:

*4. Is this shadow box for a gift?  Yes No

*5. Name of Person Who Will Be Receiving This Gift (If not you):

*6. Street Address Where You Want This Shadow Box Shipped To:

*7. City Where You Want This Shadow Box Shipped To:

*8. State Where You Want This Shadow Box Shipped To:

*9. Zip Code Where You Want This Shadow Box Shipped To:

*10. Preferred phone number in case we have to call you:

NOTE: We understand that portions of this order blank may be bring up memories that will trigger your grief and emotions but, you loved your pet and we need all the information to best immortalize him or her.

SHADOW_BOX_INFORMATION REQUIRED  TO CUSTOMIZE YOUR MEMORIAL:

*11.Size Of Desired Shadow Box (click right side down arrow for a list of all sizes and prices (delivered)  then click on your choice:

*12. Type of animal (e.g. Dog, Cat, Bird, Horse, etc.): 

*13. Describe the breed (e.g. Terrier, Tabby, Parakeet, Appaloosa, etc.): 

*13. Pet's Name or Nickname:

*14. Date of Pet's Birth (e.g. 03, 20, 1990): 

*15. Date Went To Pet Heaven (e.g. 10, 19, 2001): 

*16. Subtitle or caption to appear at the top of your pet's memorial - Please limit to 30 characters:   (To see examples, click here ):

*17. Pet owners full name: 

*18. Is Pet A Male or Female:  Male Female

*19. Do you want to order the optional $10.00 "Mini Cremains Urn" and have it placed on your memorial Yes No

The Tribute To Your Pet's Life:

Capsulate your pet's life in this shadow box memorial that honors him or her to ensure your pet is remembered the way you want. Tell us those things about your pet that will help the designer best honor him or her.

List Of Memorabilia You're Sending To Us:

Please tell us what to expect in the way of your pet's memorabilia so the designer can begin to think of the best design to memorialize your friend.

 

*20. This question will keep spammers from using your information. The question is; If winter is cold, summer is? (hint; rhymes with "not")

   For office use only.
Please do NOT enter anything in this box.

About Us  |  Our Humane Rescue Facilities
Coping With Pet Loss  |  Make A Donation  |  Contact Us  |  Home