Application for Grave Plot Licence
Please use this form for advance booking of a grave plot for coffin or cremated remains. The
Alne Wood Park Burial Ground Licence grants the Licence Holder the right to be buried or to
nominate another person to be buried, in the grave plot purchased.
□
Application for (tick)
Burial Plot (£800)
□
□
Single Cremated Remains Plot (£240)
Family Cremated Remains Plot (£590)
Licence Holder Details
Full Name*:
__________________________________________________________________________
Address*:
__________________________________________________________________________
__________________________________________________________________________
__________________________________ Post Code*: ___________________________
Telephone*:
Email
________________________________ Mobile _________________________________
________________________________________________
(*must be completed in all cases)
Declaration
I declare that I have read and understood the Alne Wood Park Cemetery Regulations, and I
agree to abide by them.
Signed by or on behalf of the Licence Holder:
Print Name:
Application Date:
______________________________________________
___________________________________________________________________________
__________________________________
Payment attached: £ _________________
Data Protection:
Hemming & Peace Ltd (on behalf of The Heart of England Forest Project) will securely hold your details for the
purposes of operating the burial site. We may wish to contact you in the future regarding news and other services that
we offer. Please tick this box if you prefer not to be contacted for reasons other than cemetery administration
□
Alne Wood Park Burial Ground is operated by Hemming & Peace Funeral Services on behalf of The
Heart Of England Forest Project. This form should be sent, with the payment, to:
Alne Wood Park Burial Ground
c/o 67 High Street, Alcester, Warwickshire, B49 5AF
Telephone: 01789 400203