Date: ________________

Schaefer Lettering, Inc.
17080 Monahan Drive
Altura, Minnesota 55910
Phone: (507) 456-9477   Fax: (507) 796-0125


Family Name:  _________________________________________________________

Customer Name:  _______________________________________________________

Address:  ______________________________________________________________________

City, State, Zip: _____________________________________________________________________

Email address: _________________________________________________________

Phone: _______________________________________________________________

Cemetery Name and Location: _____________________________________________________________________

Description of monument: ____________________________________________________________________

ENGRAVING NEEDED                      MAP OF MEMORIAL LOCATION
                                                                                                                          








Total Cost: _____________

Less Deposit: ___________ (Check # _______)

Balance Due: ____________

I have read this contract and fully understand its provisions.  By signing, I acknowledge my agreement to the terms and conditions set forth within.


_______________________________________________________________
(Signature of customer)


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