Request a Collection Kit Thank you for choosing Fields and Fields Memorial Glass to create a memorial keepsake for your loved one. Please fill out the form below. We will mail you a collection kit with instructions, a container for the ashes, and a priority express envelop with an address label for sending the ashes back. The cost for sending cremains priority express is approx 24.00. Please pay the return postage at the post office before dropping the envelop off to be mailed. Name*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* PhonePerson or Pet*PersonPetName of Deceased* This iframe contains the logic required to handle Ajax powered Gravity Forms.