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Hamiltons Agate Order Form
Funeral Home Urn Plaque Order
PLEASE NOTE!
USE PROPER TEXT
ex: John A. Adams
Funeral Home Ordering
*
McLarens
Caldwell Parish
Date of Service
*
+
Enter your FSC/Director email address
*
Deceased Official Name
*
Month of Birth
*
January
February
March
April
May
June
July
August
September
October
November
December
Day of Birth
*
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Birth Year
*
Month of Death
January
February
March
April
May
June
July
August
September
October
November
December
Death Date
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Death Year
Select a Shape
*
Beveled Edge
Domed Top
Oval Shape
Scalloped Edge
Select Plastic Color
Plastic Black with Gold Text
Plastic Silver with Black Text
Plastic Gold with Black Text
Plastic Copper with Black Text
Choose Faux Wood Finish
Maple Wood
Cherry Wood
Ebony Wood
Text Color Wood
Natural
Color Fill (No Border)
Graphics
None
Scroll
Cross
Praying Hands
Deer
Pheasant
Fish
Enter Script to be Engraved (If Any)
Male
No Script
Husband
Loving Husband
Beloved Husband
Father
Dad
Grandfather
Grandpa
Great Grandfather
Great Grandpa
Grandson
Son
Brother
Uncle
Nephew
Friend
Female
No Script
Wife
Loving Wife
Beloved Wife
Mom
Mother
Grandmother
Grandma
Great Grandmother
Great Grandma
Granddaughter
Daughter
Sister
Aunt
Niece
Friend
Enter any comments or changes
Baby
Yes
No