Memorial Order Form

Your Name (required)

Your Email (required)

Address (required)

Name of Deceased (required)

Please select Burial Ground (Required)
Please select belowPrestwoldScraptoftWrottesley Park

Plot number (if known)

Memorial Trees:
—Please choose an option—Silver BirchRowanCrab AppleHazelHollyField MapleLindenWild CherryOak

Encouraging Nature

Bird Nesting Box:
Bat Roosting Box:
Hedgehog Home:
Bee, Bug or Insect Home:

Memorials placed upon graves are subject to the following:

You must be the legal owner of the grave (if acting on behalf of another, written explanation/consent must be provided) in order to erect a memorial and/or plant a tree on the burial plot. Unauthorised memorials will be removed if requested by the registered owner of the grave plot.

Section 2 – Plaque Details

Slate Plaques

Please clearly write the required inscription in the box below. Use upper and lower case letters as required and check all spellings. Our team will replicate this as the authorised inscription.

The Grave Marker Plaques can be up to 5 lines of text. A maximum of 18 characters, including spaces, per line. If a motif is requested the text is reduced to a maximum of 3 lines. (PLEASE check your spelling).

You can state what you wish; the key is that any inscription is appropriate to you and your loved one.

Grave Marker Plaque (5 lines Max) :
Grave Marker Plaque with Motif (3 lines Max):

Please enter text below:



140

I request that the plaque inscription is cut as above. I understand that as each plaque is unique I am responsible for any inaccuracies in the inscription and that I will be liable for additional costs if the plaque/memorial bench is engraved incorrectly as a result of a mistake in the above.

Signature: (please draw on within the box with your mouse or finger).

Please type your name

Date

Payment by BACS to: Natural Burial Company. Sort Code 56-00-55 Account 91216079

Please state your name as payment reference: The Natural Burial Company, The Estate Office, Prestwold Hall, Loughborough LE12 5SQ