Order Form

Please copy and paste the following form and fill out all with * in front of it. Pay AFTER you fill out the order form and have emailed it to ahovatermarkmylove@yahoo.com and have received a confirmation email.



Each piece is $400.00 plus tax.

Order number_________ SS RS LS Custom Portrait RS CS

*Customers Name-_____________________________________

*Phone Number-______________________________________

*Name of Deceased-__________________________________

*Date of Birth of Deceased-_________________________

*Date of Death-______________________________

*Colors 1._________2._________3._________4._________

*Image/Images_______________________________________

*Religion-__________________________________________

*Notes-____________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________



Date of Order ________________________

Date of Shipment/Setup _____________________


Date of Completion ____________

Completed by _________________________________


______________________________________
Artists Signature