PROGRAM ORDER FORM

Program Order Form Levett Modern Design

Service Information
Program Selection
Portraits & More
Upload Documents
Review & Submit

Order Number / Case #

Date:

Time Submitted:

Primary Director:

Secondary Director:

Family Information

Deceased Name:

Contact Person’s Name:

Email Address:

Mobile Number:

Service Information

Date of Birth:

Date of Service:

Location of Service:

Pastor’s Name:

Date of Death:

Time of Service:

Interment:

If not interment please enter “N/A"

Cremation:

Yes

Viewing:

Yes

Viewing Date:

Viewing Time:

Program Information

Package Selected: If NOT a package, please indicate quantity in special instructions section.

Bifold

Deluxe

Triflod

Trifold

Medium

Deluxe

Triflod

8-Page Book

Medium

Deluxe

12-Page Book

Medium

Deluxe

Upload Program Documents and Photos (pdf, jpeg, png)

Up to 2 files, Max size - 1 MB per file.

Design Number:

Program Delivery Location:

Portraits & More

Only provide information that should be printed on the portrait

Do you want to order a portrait?

Yes

Include Name on Portrait?

Yes

Include Dates on Portrait?

Yes

Deceased Name:

Deceased Photo

Upload Deceased Photo (jpg, png & pdf)

Up to 4 files. Max size: 1 MB per file

Date of Birth:

Date of Death:

Number of Portraits Needed:

Portrait Delivery Date:

Delivery Time

Portrait Delivery Location (Choose One):

Cremation Care

Flat Shoals

Gwinnett

Rockdale

Scottdale

Choose a portrait treatment:

Full Image

Double Mat

Full Image: This image features a print that fills the frame. Requires 48 Hours for delivery. Weekend and Monday deliveries must be placed by 10 am Thursday.

Double Mat: This image features a Custom Premium Double Matboard with Antique White and Metallic Gold mats.

Choose a frame color (Frames are 18x24):

Brown

Black

Brown-Bronze

Black Bevel

Brown: This frame features an oak colored finish and a beveled construction that won’t detract from the work placed inside.

Black: This frame features a Black Smooth Wood Wall frame features a matte black shell with a fillet around the glass.

Brown-Bronze: This frame features a rich brown-bronze finish with subtle metallic undertones and a beveled construction that adds depth while complementing the artwork inside.

Black Bevel: This frame features a sleek black finish with a beveled edge design that enhances dimension and provides a clean, modern presentation without overpowering the display.

Additional Items Needed:

Bookmark

Thank You Card

Prayer Cards

Pull Up Banner

Foam Core Board

Foam Core Board w/QR Core

Bookmark Qty

Thank You Card Qty

Prayer Card Qty

Pull Banner Qty

Foam Core Board w/QR Core

Foam Core Board Qty

Upload Documents

Upload Method:

Direct Upload (max 10 photos)

Google Drive / Dropbox Link (Recommended for large files)

Upload ZIP File (one file)

Upload Photos: up to 10 photos- jpg, png & pdf *

Max size: 1 MB max per file

Google Drive / Dropbox Folder Link

(For 10–50 photos and documents upload them to Google Drive or Dropbox and paste the folder link here.)

Upload ZIP File (All photos and documents in one file)

Upload ZIP File
(All photos and documents in one file)*

(Max size: 25MB)

Review your details

Service Information

Order / Case #

Primary Director

Deceased Name

Contact Person

Service Date

Service Location

Program Information

Selected Program

Design Number

Program Delivery Location

Portrait Information

Want to order portrait

Number of Portraits:

Date of Delivery: at

Location of Delivery:

Portrait treatment:

Color of frame:

Program Delivery Location

Attached Photos & Docs

Program files:

Deceased Photos:

Additional documents:

Please review all information carefully before submitting your order. If any changes are needed, use the Previous button to return to the appropriate section and make corrections.

Checkbox Field

I agree to the terms and conditions.