Print out this form and then

You may fax , e-mail us, or phone in your order , or ask us a question!

*I N S T R U C T I O N S   A B O U T    S E N D I N G       P I C T U R E
Sending the Picture:
1. Please send the clearest picture possible it can be up to 8" x 10" (Picture is returned with order).
2. Pictures are made a vertical bust (Please state on back of picture your selection).
3. Please include any special instructions on the back of picture (we will try our best to accommodate them).
4. Changes free of charge: - Masking of unpleasant background (white, gray, black or sky blue only). - Two or more persons on a picture (if only one picture is supplied). - Reversing picture (mirror image). - Black & white from a color picture. You may also fax this order and send picture via E-mail as a attachment.

Mail Picture To:....Starlight Memorials Attn: Order Processing Dept.
42 Kukuk Lane,
Kingston N. Y. 12401

|Special Instructions | Please use field for special cropping instructions

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Product
Size	Picture Number	Other	Hortizontal (----)	Vertical (|)|	Price
FREE Ground Shipping! Expedited delivery charges apply. Call us for free rate quote on expedited shipping cost toll free at 1-800-260-2201:
New York State residents add 8% Sales Tax!
Total Amount:

Billing	Shipping Product is (shipped signature required with FedEx Overnight.)
Date	Name
Name	Attn:
Address	Address
City	City
State ______________________Zip ________	State ______________________Zip ________
Daytime Phone	Daytime Phone
E-mail	Fax Number
Check...... (or).... Money Order...... Visa ..Master.. Card ....American Express .........Discover
Name on Card
Card Number________ ________________________CCV __________Expiration Date __________
Signature
By signing this document I agree to the terms and conditions on the Starlight Memorials web site. Starlight Memorials.. 42 Kukuk Lane ..Kingston.. N.Y. 12401 Memorial Products, Grave Markers, Cremation urns , Home & garden Products Toll free 1-800-260-2201------Fax Number 1-845-382-1629