Wall-Custance Funeral Home & Chapel Home Page - Memorial Forest Progarm

	(Wall-Custance Funeral Home Ltd.)

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WALL-CUSTANCE MEMORIAL FOREST PROGRAM

On-line Order Form
The planting of a tree can be arranged through Wall-Custance Funeral Home and Chapel. The family of the deceased receives an In Memoriam card, stating that a tree will be planted in the Memorial Forest, in memory of their loved one. The name of the deceased is engraved on the Memorial Forest Wall at the Wall-Custance Funeral Home as well as being published in the local paper, prior to the annual dedication service. It will also be printed in the Dedication Service brochure.
The current cost of having a tree planted is $50.00 Canadian.
Make cheque(s) payable to the University of Guelph or enter VISA/Master Card below
A receipt for income tax purposes will be issued by the University of Guelph.

To order a tree contact Wall-Custance Funeral Home or complete our
ON-LINE ORDER FORM below to e-mail to Wall-Custance for processing.
You will receive confirmation that your order has been processed from Wall-Custance.

* These fields are required to submit this form:

Note: THIS IS NOT A SECURED SITE. IF YOU PREFER YOUR ORDER MAY BE FAXED or MAILED.

In Memory of:*

Year of Death:*

Send Card to (Name):*

Street Address:
City/Town:		Province/State:
Country:		Postal/Zip Code:

Sign in Memoriam Card From:*

Send Receipt to (Name of donor):*

Street Address:
City/Town:		Province/State:
Country:		Postal/Zip Code:

Charge to Account (select one):

Card Number:

Cardholder Name:

Expiry Date (mm/yy):

E-mail:*:

Telephone:

Fax:

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Wall-Custance Funeral Home & Chapel
E-mail: mail@wallcustance.com ~~ Website: www.WallCustance.com