Embracing Eternal Memories
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Custom Order Form
Embracing Eternal Memories
1231 Pershing Rd
Moses Lake Wa 98837
1-509-793-4156
*Name
*Address
*Email
*Phone number
*Item in Memory of
Amount enclosing for Deposit?
What Garments are you enclosing
I am ordering a quilt
Infant size- $25.00
Wall Hanging-$25.00
Twin size-$50.00
Double- $75.00
I am enclosing pictures
I am ordering a bear
Bear-$25.00
I am enclosing a picture-
I am ordering a photo album-$20.00
I am enclosing a photo
I am ordering a pillow-$15.00
I am enclosing a picture
Any special instructions
We will contact you when we receive your form with a total amount due. You can figure this out with the prices posted. Total the price of the item and add $.50 per picture you would like used. All pictures and remaining fabric will be returned to you unless otherwise specified.