Cremation Plan Application

1) Person to be covered by the plan

Documents are usually sent to this person.

Title
First Name
Surname
Address 1
Address 2
Address 3
Postcode
Tel
Mob
Email
Date of Birth

Ashes: Please indicate your wishes in respect of the ashes

I wish to have my ashes returned to my family or nominated representativeI wish to have my ashes scattered in the Garden of Remembrance at the crematorium

2) My Nominated Representative

The Nominated Representative is the person who will be the contact for your funeral and will notify us of your
passing when the time comes.

If you choose not to provide a Nominated Representative please tick here

Title
First Name
Surname
Address 1
Address 2
Address 3
Postcode
Tel
Mob
Email
Relationship to Plan Holder - eg Son, Daughter, Husband, Wife, Partner, Friend.

We will write to your Nominated Representative within the next 5 business days to let them know you have purchased a plan with us. We do this so they are aware of your wishes and so minimise the risk of the plan going unclaimed at the time of need.

Please tick here if you DO NOT want us to contact them