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Blue Ridge Monuments
Death Date Form

We accept all major credit / debit cards. Please call our office at (828) 652-2936 to make payments by phone. Or remit checks / money orders to P.O. Box 63, Marion, NC 28752.

First Name: Last Name:

Street Address or P.O. Box:


City: State: Zip Code:

Phone:

E-mail:

Location of the Cemetary:

Location of the Grave in the Cemetary:


Double or Single Stone:


Name or Names as on Stone:


Birth Date of Individual:
____________________ (Give date even if already on monument)

Death Date:
___ _______ (Please enter as it will appear on stone)

Comments:

 
 
 
 

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