Mourninglights™ Order Form
Mourninglight custom printed glass memorial candle

Please fill out the following short form and click the submit button at the bottom of the page to send us your information.

You'll have a chance to review your information before uploading your photo to us.


Code (optional):

Photoguide Page (optional):

Personal Information


Daytime Phone Number:

E-mail Address:


A volume discount of $4 per Mourninglight™ is applied to orders of 10 or greater of the same print. This discount is credited after your order is reviewed within 24 hours after checkout. Or write to us for a custom invoice by email at .

Choose Your Light Type

Please choose either the free wax 15 hour votive or the 36 hour battery light for an additional $3. The battery lights have an on /off switch and the batteries are replaceable.

Wax Candle mourninglight memorial candle Pink LED Pink LED battery light mourninglight memorial candle Amber LED Amber LED battery light mourninglight memorial candle

Or choose our gently flickering 36 hour amber battery light for $4 below:

Flickering Amber LED

Your inscription

Please write in the inscription boxes what you would like to appear on your Mourninglight™ . Each line can contain a maximum of 30 characters.

Line one:
Line two:

A third line is available for an additional charge of $3.
Line three:

Memorial Gifts

Are you giving this Mourninglight™ as a gift?
Choose either to have your name printed on the reverse or include a gift card at no extra charge. Print your name in the text box. (Maximum characters: 30)

A Gift from


Use the space below to write a message which we'll include on a gift card. Please include your name as you would like it to appear.

(Maximum characters: 150)
You have characters left.