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Gemini Bronze Memorial Canada Order Form
Canada:
373 John St, Box 268 • Neustadt, ON. N0G 2M0
Canada@GeminiSignProducts.com • 1-800-265-0426 • Fax 1-519-799-5954
BILL TO:
*
Customer #
P.O. #:
PHONE:
*
FAX:
CONTACT NAME:
*
EMAIL:
*
SHIP TO IF DIFFERENT:
BRONZE MEMORIAL
MEMORIAL STYLE
*
TIMELESS
SENTIMENTS* (Vector art required)
U.S. GOVERNMENT MATCH
W-N ART BRONZE
NICHE
ITEM NUMBER:
Gemini Bronze Memorial Item List
SIZE:
*
BORDER DESCRIPTION:
*
VASE:
*
NO VASE
ATHENS VASE
TUSCAN VASE
SCROLL
DATE FORMAT:
*
YEAR ONLY
Month/DD/YYYY
SCROLL STYLE
*
NO SCROLL (Cast Integral)
STANDARD UNICAST
CLASSIC UNICAST
ADDITIONAL INFORMATION:
LETTER STYLE
STYLE
*
FLAT
OVAL
U.S. GOVERNMENT
COLOR
BACKGROUND
*
VA MATCH BROWN
DARK BROWN
LIGHT BROWN
BLACK
MAROON
GREEN
DARK BLUE
OTHER
IF OTHER:
EMBLEMS
Gemini Bronze Memorial Emblems Catalog
(1) STANDARD ITEM #:
(2) STANDARD ITEM #:
(3) STANDARD ITEM #:
(4) STANDARD ITEM #:
(5) CUSTOM:
IF OTHER:
SCULPTED
FLAT
(6)CUSTOM:
IF OTHER:
SCULPTED
FLAT
(7) CUSTOM:
IF OTHER:
SCULPTED
FLAT
(8) CUSTOM:
IF OTHER:
SCULPTED
FLAT
LAYOUT
TYPE:
*
COMPANION
INDIVIDUAL
SURNAME:
*
FIRST NAME:
*
BIRTH DATE:
*
DEATH DATE:
*
SECOND NAME:
BIRTH DATE:
DEATH DATE:
ADDITIONAL INFORMATION:
ARTWORK
TYPE IN LAYOUT
OR UPLOAD ART / DRAWING