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Eternal Star
Gold Memorial Webpage
Order Form
Website Recipient's Name:__________________________
Birthday:__________
Purchaser Name:__________________________________
Address:_________________________________________
________________________________________________
City:__________________________
State:______ Zip:__________
Telephone:_______________ Email:__________________________
Credit Card Number:__________________________
Expiration Date:__________ Security Code:______
Upon receipt of your order, Eternal Star will send you a UPS 2nd Day tracked shipping envelope to pick up your photographs, slides, and written copy.
Place a copy of this order in this envelope with your materials
- Include a copy of the written material you wish to have placed on your webpage in the package
- Count the number of photographs enclosed
- Number the photographs lightly in pencil on the back side and include a list of the captions for each picture
- You may alter captions and other copy at a latter dates
The number of photographs enclosed is:________________
Call UPS at(800) 742-5877 for free shipment pickup.
This shipment will be tracked by UPS and you will receive confirmation by Eternal Star, Inc., upon its receipt. We will call you at your telephone listed below, or via email or FAX, whichever you prefer.- Your Email
- You Telephone
- Your Fax
Print this order form and mail it to us with your materials, or fax it to us and we will send free shipping materials to you.
A one-time fee of $75.00 will keep 15 of your photographs and memorial text posted on the internet forever.
Mail to: Or FAX to (219) 769-6035 For telephone order, please call (219) 775-5752 Our email is:
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