Because Style Matters Order Form Order Form Personal Information First Name * Last Name * Email * Phone * How Did You Hear About Us ? * Side One of Wings FULL NAME OF DECEASED SIDE ONE * First Name * Last Name Date of Birth Side One * Date of Death Side One * Tips Side One Left * Military, 2 hearts, golf, butterflies, be creative Tips Side One Right * Military, 2 hearts, golf, butterflies, be creative Poem Side ONE * Pick a Poem # or send me your own via email Side Two of Wings FULL NAME OF DECEASED SIDE TWO (if different from side one) * First Name * Last Name Date of Birth Side TWO (only if different from side one) * Date of Death Side TWO (only if different from side one) * Tips Side Two Left * Military, 2 hearts, golf, butterflies, be creative. (see sample at bottom of form) Tips Side Two Right * Military, 2 hearts, golf, butterflies, be creative Poem Side TWO * Choose a poem number from site or send me your own in comments below. Pick Your Wind Chime Choose Style of Windchime * SelectMaryKatrinaIleenRuthKatjaSoleilArielButterfly LoveAngel BugRibbon AngelAngel DogBriannaOTHER - REMARKSKeychainGuardian Angels Color of Chime (Text Preferred) * May substitute if color not available Scroll Personalized * SelectYesNo Dear * name of person receiving gift Love * name of person who passed String * Choose a word you would like on the string (i.e Love, Family, etc) Add Flying Butterfly * SelectNo ThanksBlue ButterflyHe Has Risen ButterflyMilitary Butterfly Include Gift Card * SelectYesNo Method of delivery * SelectMailed ($6.99)Pick-upLocal Hand Delivery ($10) If YES, what would you like the card to say? * Name of Recipient (If mailing) * First Name * Last Name Address * Street Address Street Address Line 2 City * State / Province * Postal / Zip Code * Additional Info Once I have received your form and reviewed it,I will create a draft for your approval. Once you approve the the final draft, I will send you an invoice, which will need to be paid before ordering the engraving. If something does not apply or you, use NA or if you do not know what you want, please enter "help" and I will contact you. Please check your email regularly as I will check with you if I have any questions. If you would like, you can email me a copy of the obitury (if applicable) to angelgirl@whisperingwingschimes.net. which will help me help you with ideas if needed. IF YOU ARE HAPPY WITH YOUR PURCHASE, PLEASE GO TO MY SITE WWW.WHISPERINGWINGSCHIMES.COM AND LEAVE A COMMENT AT THE BOTTOM. THEY MEAN THE WORLD TO ME. Submit If you are human, leave this field blank.
