This order form was designed to be used by our customers who have
established a customer number and a line of credit with us. This is to avoid
working with credit cards on the internet. If you would like to receive a
customer number and line of credit please call us at 800-831-8568.

Register Books:

Quantity Item No. Description

From KM Records New Imprint

Enter your imprint in the space provided.

Memorial Folders:

Quantity Item No. Description

From KM Records New Imprint

Enter your imprint in the space provided.

Acknowledgement Folders:

Quantity Item No. Description

Miscellaneous Items:

Quantity Item No. Description

From KM Records New Imprint

Enter your imprint in the space provided.

Billing Address:

Customer Number:
Funeral Home:
Name:
Address:
Address 2:
City:
State:
Zip:
Phone:
Fax:
Email:

Shipping Address if different from above.

Funeral Home:
Address:
Address 2:
City:
State:
Zip:

Please check which form of shipping you wish to use:

UPS Ground delivery
UPS 2nd Day delivery
UPS Overnight delivery
FedEx delivery