BOOKING FORM

Date of booking: Full Name of Deceased: Address of deceased:

Date of Death: Age: Next of Kin details: (Including, name, address, telephone & email address)

Funeral Director Name and Address (if applicable)

Date and time of funeral: Funeral Type: • Burial [ ]

• Interment of Ashes [ ] • Other [ ]

Plot Description • New Single Plot [ ] • Double Plot [ ]

Plot Location and selection (for office use only)

Environmentally friendly Coffin/Shroud type:

Coffin / Shroud/ Urn Dimensions:

Approximate number of mourners attending?

Terms & Conditions Signed? Price Agreed: (see price list) Payment method: (See price list for payment details)

Cheque [ ] Made payable to: Mr. H A Edmunds. BACS [ ] Account name: Mr. H A Edmunds Account number: 00851844 Sort Code: 30-97-41

The Estate Office, Cholderton, Nr Salisbury, Wiltshire, SP4 0DR

www.woodlandburialscholderton.co.uk Telephone: 01980 629203 Email: admin@woodlandburialscholderton.co.uk