St Stephen’s Parish Church

Hightown

GARDEN of REMEMBRANCE

Request for Interment of Ashes

I / We request that the cremated remains

of _________________________

be interred in the Garden of Remembrance.

I / We understand and accept that the ashes will be buried underneath the turf of the garden; that no markers of any kind are at any time to be placed, and that fresh cut flowers only may be placed on the grass of the garden in tribute.

The fee in 2015 for an interment as above is £163.00 to be paid as cheque to St. Stephen’s PCC.

Signature ____________________

Signature ____________________

Date ________________________