ANNIVERSARY MEMORIAM – Mon Valley Independent Forms

In loving memory of our beloved*

Name of deceased*

who passed away*

years ago today*

Verse: please include your own verse or stop by our office to view our book of verses

Sadly missed & loved by

Contact Information - Your contact information below is solely for use by our staff and will not be published.

Submitters Name*

First

Last

Submitters Address*

Street Address City State / Province / Region Postal / Zip Code

Submitters Phone:*

Submitters Email*

Cost: you will be contacted by our office with pricing information

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