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Dedication of Lights Order Form

Please Complete 1 form for each Star and Luminary Package *	Quantity
$15 - Dedication of Lights Star and Luminary Package

Contact Information

Your Name

First Name

Last Name

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

1. Name as you would like to see it on the star

Is this a person or a pet?

Person

Pet

Is this in honor or memory?

Honor

Memory

If you would like us to send an acknowledgment to someone special please provide their information