Application to Purchase Exclusive Right of Burial - Reserved Plot

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Applicant Details

First name *

Middle name (optional)

Last name *

Address *

Email *

Phone (optional)

Mobile (optional)

Cemetery *

Type of Plot required (optional)

Lawn

Ashes

This Plot is for use by the following nominated person(s)

First name *

Middle name (optional)

Last name *

Date of birth *

Years in District *

Comments (optional)

If you have spoken to council and have selected a plot, please enter this information here

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