LUMINARY ORDER FORM

PLEASE READ: We will be lighting our angel luminaries this year in remembrance for our lost loved ones. Each luminary is $10, and payment is due after the completion of this form. All order forms must be turned in by Saturday, May 10th in preparation for our ceremony. Once you fill out this form and hit ‘submit,’ you will be redirected to our general donation page. Please type in ‘$10’ in the amount box and add ‘luminary’ to the note section directly underneath. Make sure you have ‘One time’ payment box selected. Then, you will be able to add your card information.

Childs Name

First Name

Last Name

Child's Date of Birth

MM

DD

YYYY

Child's Date of Death

MM

DD

YYYY