Include a good clear .jpg on IBM compatible disc or a 4x6 or larger photo of your pet for the custom PHOTO bridge poem. All items will be returned in the same condition as they arrived, along with the Bridge Poem.
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Name:
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______________________________________________________________ |
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Address:
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______________________________________________________________ |
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City:
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_______________________________State/Prov________Zip____________ |
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Phone:
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Home_____________________________Wk__________________________ |
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E-Mail Add:
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______________________________________________________________ |
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Signature:
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______________________________ 4x6 Photo Enclosed? YES / NO |
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Poem Choice:
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Laminated 8 1/2 x 11 Customized Bridge Poem $9.95_____With Photo $19.95___ |
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Pet Name:
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__________________________Birthdate_________Deathdate____________ |
| 2nd Pet Poem Name: | __________________________Birthdate_________Deathdate____________ |