Bereavement Services
The Memory Tree
Application for the lease of a Memorial Leaf Dedication (10 Years)
Conditions of the Lease:
- The period of the lease is for 10 years. Payment must be made in full at the time of the application.
- The dedication may be renewed after this time. The applicant is responsible for contacting the Crematorium Office in order to renew the lease.
- Applicants must inform the Crematorium Office of any change of address.
- If the lease has expired without being renewed the leaf may be removed without notice and the space leased to another person.
- The leaf plaque provided with the inscription remains the property of the Council at all times.
- No other containers or memorabilia are to be placed in this area - items will be removed.
Full name of deceased
Location of the memorial leaf
Left
Right
Please indicate
desired placement
Pontefract Crematorium
Wakefield Crematorium
INSCRIPTION: Top and bottom lines preferably kept shorter
(25 Characters/spaces) to account for the curve of the leaf.
Middle lines can have 35 Characters/spaces.
Names will be enlarged and all text centered wherever possible.
The Crematorium reserve the right to alter the inscription if it is
deemed necessary.
Inscription
1)
2)
3)
4)
5)
Name of Applicant :
Address :
Telephone number :
Email address :
I have read and agreed to comply with the regulations above, and enclose payment for £
payable to Wakefield Council (send to Bereavement Services, Block B, Town Hall, Normanton WF6 2DZ).
Please ring Bereavement Services on 01924 307446 to make card payment.
Signature :
Office use only
Agreement number
Plaque number
Date Paid
Receipt number
Lease starts
Lease ends
Cremation/Burial Register number
Epilogue number
Please check up-to-date price list available on
http://www.wakefield.gov.uk/residents/community-and-housing/births-marriages-deaths/deaths/burial-cremation/memorials