ORDER FORM EVERGREEN WEB SITE MEMORIALS

MEMORIAL ORDER FORM EVERGREEN WEB SITE

Please share with others who may not have internet access. Thank you.

A memorial may be donated by anyone for anyone with an Evergreen connection. The memorial order form needs to be completed by the memorial donor who determines the precise language for the memorial, as follows:

Top Line: Full name/s, including maiden & nick (if wish to use), of person/s memorialized (limited to two persons per entry, unless it is a family name which can be placed on one line);

_____________________________________________________________________________

Next line/s: Narrative about person/s being memorialized (limited to 100 characters);

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Next line/s: Name/s of memorial donor/s – (options include the following):

1. The name of a single donor;

2. Donation by a couple of people, like a husband and wife (Please provide names in the manner you wish for them to be listed – example Joan Smith Nelson and Harry Nelson;

3..If by the children, all could be listed on donor application (no limit);

4. Other examples: "From his/her or their loving family" “From Your Friend”
5. Leave blank.

_____________________________________________________________________________

_____________________________________________________________________________

The memorial agreement will allow the memorial donor/s to submit a maximum of two pictures for placement in the memorial link. These could be of the person/s being memorialized and/or of the memorial donors. .

The donation for a memorial is $36.00. This will cover the posting of the memorial for three years. The donation for memorials received after the start date of July 1, 2008 will be prorated. All agreements will end on June 30, 2011. An extended agreement is anticipated.

Check/s should be made out to EvergreenLA.org Memorials and mailed to Ed Dugas at the address below. The RE or SUBJ should include the name of the person/s being memorialized

Your memorial donation will be acknowledged in a timely manner. Please include the caption information on the picture/s you plan to send. Please send the pictures electronically or mail in regular mail. This is risky, so you are encouraged to have the picture/s scanned and emailed to me.

Contact information for Ed Dugas ead9743@louisiana.edu; 731 Brasseaux Rd., Carencro, LA 70520; (337) 896-4335.

Check No:___ Date of Check:______ Check Account Name:_________________ Amount$___