Gonzalez Funeral Home Order Form (new)
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Email *
Delivery Location *
Funeral Director *
Funeral Director Email Address *
Name of Deceased *
Case #
Delivery Information
Flowers will be delivered 2 hours prior to viewing, visitation or service.
Will there be a private viewing? *
Private Viewing Date
MM
/
DD
/
YYYY
Private Viewing Time
Time
:
Will there be a visitation? *
Visitation Date
MM
/
DD
/
YYYY
Visitation Time
Time
:
Service Date *
MM
/
DD
/
YYYY
Service Time *
Time
:
Include aBud Vase? *
# Boutonnieres at no charge (up to 8) *
# Additional Boutonnieres @ $12.95 each *
Family Piece #1 - Enter Quantity, Description & Price *
Family Piece #2 - Enter Quantity, Description & Price
Family Piece #3 - Enter Quantity, Description & Price
Family Piece #4 - Enter Quantity, Description & Price
If ordering a casket piece, should it be a half or full?
Clear selection
If ordering a piece that will include a photo, what is the overall size of the photo (including frame)?
Confirmation of color scheme
Clear selection
Order Total $ *
Enter Order Total (Total amount for family pieces & additional boutonnieres)
Additional Information
A copy of your responses will be emailed to the address you provided.
Submit
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