Photo Tribute Order Form

Please contact MemoryBasket via Email or Call prior to or after submitting form to ensure delivery of order/booking details – Thank you

Deceased Name *

First

Last

Deceased Year of Birth/Year of Death *

Family Contact Name & Relationship *

Family Contact Email (if applicable)

Family Contact Phone No (if applicable)

Funeral Director Name and Branch *

Funeral Location *

Funeral Date and Time *

Who will send photos *Funeral DirectorFamilyPick up from Funeral Home

Order of Photos *

• Random
• Numbered

Main/Hold Screen

• Hold screen selected
• Background theme selected

Main/Holdscreen Details

Include Holdscreen wording and background theme, if applicable.

Package *

• One Song Photo Tribute – up to 40 photos
• Two Song Photo Tribute – up to 80 photos
• Three Song Photo Tribute – up to 120 photos

Song/s Title and Artist (Please No. in order) *

Service Music *

• MemoryBasket to provide (add below)
• Not required

Opening Song (Title and Artist)

Closing Song (Title and Artist)

Additional Music required (Title and Artist)

AUDIO VISUAL REQUIREMENTS (includes Technician to operate Photo Tribute and Service Music at Chapel/Church)

• Laptop, Speaker only
• Full Audio Visual Equipment (Projector, Screen, Laptop and Speaker)
• Technician Only

Addition Information (if required)

Submit