Memorial Paving Stone Request Form

"*" indicates required fields

The stone will be installed in the oval brick walkway surrounding the central lawn in a location to be agreed upon with the burial ground manager.

Cost: $500.00
The paving stone will be grey granite, 8"x12" in face size.
Incised lettering will be all capital letters ¾” high.
Text on the stone will be limited to proper name(s) of an individual or couple, plus optional numbers denoting the years of birth and death of the individual(s), if desired. No other wording or characters will be allowed.
For living persons, stones may be installed in the initial installation with space left for the future additional dates, if desired. However, the cost of changing previously installed stones will be additional, in accordance with price schedules in effect at the future time.
A maximum of three lines of characters is recommended, and a maximum of 12 to 13 letters per line, including spaces.

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Stone Lettering Line 1 (Max 13 Characters including spaces)*

Stone Lettering Line 2 (Max 13 Characters including spaces)

Stone Lettering Line 3 (Max 13 Characters including spaces)

Please make checks payable to “Friends Southwestern Burial Ground" and send, referencing the name on this form to:

Friends Southwestern Burial Ground Committee
236 Powell Lane
Upper Darby, PA 19082

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