Advanced-Planning Purchase Order Form

Please complete the form below to make Pre-Need arrangements with Trappist Caskets. If you need a casket within the next six months, do not use this form, instead please call us at 888-433-6934.

Privacy Guarantee

All personal information provided to Trappist Caskets will be securely protected and will be used exclusively for the above stated purposes. As cloistered monks, we are well practiced in the art of privacy.

Purchaser Information

Purchaser Name*
Address*
Street Address Address Line 2 City State Zip
Phone*
Email*
Casket Beneficiary Information
Name of Person who will use the Casket*
Beneficiary Address
Street Address Address Line 2 City State Zip
Beneficiary Age
Beneficiary Date of Birth
Date Format: MM slash DD slash YYYY
Last 4 digits of Beneficiary Soc Sec Number
Funeral Home Information
Name of Funeral Provider
Provider Address
Street Address Address Line 2 City State Zip
Provider Phone
If provider unknown, enter likely shipping zipcode
Casket Selection*
Wood Selection
Wood Selection
Wood Selection
Wood Selection
Wood Selection
Wood Selection
Cross Preference
Comments or questions
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Advanced-Planning Purchase Order Form

Privacy Guarantee

Purchaser Information

Casket Beneficiary Information

Funeral Home Information