Life of :  

     DVD:     or VHS    No. of Keepsakes:

   Comments: 

Cost:  $25:00 Each Reorder  -- This Form may be printed and returned to Havenbrook Funeral Home with payment. Reorders take 1-2 days.  If you submit online, please call to arrange prepayment.

 Pickup Order  or  Mail To:

(Shipping & Handling: $2.50 for first DVD/VHS, $1:00 each additional DVD/VHS)