Shipping Option(Required) Account # Location Parent # Location Sales Rep Home Address Other
Shipping Address Please provide Shipping Address
Payment Option(Required) Please select the method by which this customer will be paying for the items in this order.
Program Fixturing (SJ) Bill-to Customer (S4) Sales Rep Budget (SH) Regional Budget (SK)
Would you like to order the Personalization Display? Yes, order the Full Personalization Display option for $1,935.00 Yes, order the 1/2 Personalization Display option for $1,097.50
Corners and medallions are available a la carte - you may add these to the comments section at the end of this order form. If ordering a la carte, please include item #, description, and quantity of the items requested .
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Price Sign Holder Options If placing an order for a price sign holder, please make your selection below:
11 X 17 Acrylic Holder ($30 each) _ #234093 6 X 6 Acrylic Holder ($10 each) _ #185743 Needing both 11 X 17 (#234093) and 6 X 6 (#185743) holders
Price Sign Holders Let us know which price signs you'd like to order. Click "+" to add more.
Options available:
11 X 17 Acrylic Holder ($30 each) _ #234093 - OR -
6 X 6 Acrylic Holder ($10 each) _ #185743
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Quantity of 11 X 17 Holders Please enter quantity you would like to order:
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Quantity of 6 X 6 Holders Please enter quantity you would like to order:
Order Personal Tributes Graphics Personal Tributes Graphics Let us know which personal tributes you'd like to order. Click "+" to add more graphics.
*Note: Each graphic requires 4 clips, please calculate and order accordingly.
Order Category Header Signs Category Header Signs Let us know which category header signs you'd like to order. Click "+" to add more signs.
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Category Header Signs Please select which categories you would like to order signs for:
Classic Commemorative Conventional Tell the Story Cremation Vaults Serve & Protect I'd like to order multiple categories
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Standard Category Signs Let us know which standard category signs you'd like to order. Click "+" to add more signs.
Please make your selection for Raised Letter 46" Signage Below:
Please make your selection for Raised Letter 74" Signage Below:
Please make your selection for Raised Letter 94" Signage Below:
Slatwall (Neutral Glace) Raised Letter 94” Signage Please select which Category of 94" Signage you would like to order:
WOOD VAULTS BLANK URNS TO SERVE AND PROTECT STEEL PREMIUM PERSONALIZATION MARKERS CREMATION OPTIONS METAL CUSTOM SIGN MULTIPLE CATEGORIES
Review the acrylic accessories available below:
Order Acrylic Accessories Acrylic Accessories Let us know which options you would like to order. Click "+" to add more accessories.
Order Urn Pedestals Urn Pedestal Order Let us know which urn pedestals you'd like to order. Click "+" to order more pedestals.
*If needing to place an order for replacement casket cuts OR custom cuts, please contact Display Solutions.
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Needing Casket Cuts? Please list out below, your casket cut needs. Each different casket cut style should be a new list item/line.
• Casket Cut Style (End, Corner, Triangle)
• Cut Type (Such as Preferred, Basic, Modular + RH/LH)
• Quantity of each cut/style
• Unit # and product name
• If an Interior Fin is needed, yes or no, and which style (Preferred, Basic or Modular)
Example: Corner Cut - Preferred LH, quantity = 2, ON9 Merlot, Yes 2 Interior Fins - Preferred are needed.
*If needing to place an order for replacement casket cuts OR custom cuts, please contact Display Solutions.
Order Casket Cuts Order Casket Cuts Please let us know which casket cuts you would like to order. Click "+" to add more cuts. Please fill out each section. *If needing to place an order for replacement casket cuts OR custom cuts, please contact Display Solution directly.
If looking to order an Interior Fin without a cut, please make your selections below.
Order Interior Fins WITHOUT a Cut Interior Fins Order Let us know which interior fins you'd like to order. Click "+" to add more fins.
Order Additional Accessories List Let us know which additional accessories you'd like to order. Click "=" to order more.
Order Slatwalls Slatwall order Additional Comments Please provide the SSB team with any additional comments or instructions here.
File Upload? If you have a file to include, please attach it here.
Would you like to receive a copy of this submission? Please select if you would like to receive a copy of this submission. A confirmation email will also be sent to you from Display Solutions after the order is placed.
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