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Monument Layout Form
Monument Layout Form
Contact Us
Customer Name:
Family Name:
Name to be placed on the left side of the monument:
Month of Birth:
Day of Birth:
Year of Birth:
Month of Death:
Day of Death:
Year of Death:
Additional phrase to be placed under this name:
Name to be placed on the right side of the monument:
Month of Birth:
Day of Birth:
Year or Birth:
Month of Death:
Day of Death:
Year of Death:
Additional phrase to be placed under this name:
Describe the emblem or phrase to be placed on the center of the monument. Please specify location.
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Phone
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609-344-9004
Fax
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609-347-6199
Stephen Collins, Manager NJ Lic. No. 3355
211 E. Great Creek Road, Galloway, New Jersey 08205
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