| Resin setting colour: |
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| Is this an add on to an order for other memorial items (or multiple ordered)? (£5 reduction in price): |
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| Inclusions of ashes or hair to be added?: |
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| Ashes / hair Collection Pack required? - a free pack will be sent on receipt of orders: |
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| Name of deceased for certificate of authenticity: |
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| Please let us know if you were referred / recommended by anyone so we can thank them: |
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| any other requests or additional info - more than one colour, more than one set of ashes or hair, due for a specific date? etc: |
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| Personalised engraved stainless steel tag added : |
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