Memorial Garden Form

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Memorial Garden Form2022-01-20T09:34:18-05:00

Today's Date *

Name of Purchaser *

Phone *

Email Address *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Name of person this purchase is for? *Provide name as you want it to appear on the stone

Burial or Plaque *Burial of Ashes (ashes are placed in the Garden)Memorial Wall (plaque only, no burial)

Status *MemberNon-Member

Date of Birth *

Has this person already passed? *YesNo

If yes, Date of Death

Would you like to have a special saying on the stone? *YesNoThis will be placed at the bottom of the stone

The special saying:

0 / 25

I understand that this is only contingent on the agreement that I will be sending in the payment needed for this request. I will reach out to St. Monica's to confirm the agreement.

Yes, I agree with the terms and conditions.

Signature *

Start signing your signature here

Make your check payable to:
St. Monicas Memorial Garden Fund

Mail it to:
St. Monica's Episcopal Church
7070 Immokalee Road
Naples, FL 34119
ATTN: Memorial Garden Fund