South West Middlesex Crematorium Board

APPLICATION FOR 'ARBORIA' MEMORIAL PLAQUE

Please choose the number of lines you require:

N.B. LEAD TIME FOR ALL MEMORIALS IS 10 WEEKS

Line 1: Name

Line 2:

Line 3:

Line 4:

Line 5:

Line 6:

Line 7:

Line 8:

Text line: Maximum 32 characters, if text only. Maximum 25 characters if motif requested.

Motif (Portrait) required:

Details of person making this application (BLOCK LETTERS PLEASE):):

Full name
Title
Address

Contact telephone number (in case of queries)
Email address

Signed
Date

Scale of charges:

What style of plaque would you like?

How long do you want the plaque to be displayed?

Style	Term	Total cost
1	2	3

Cheques payable to SOUTH WEST MIDDLESEX CREMATORIUM BOARD
HOUNSLOW ROAD, HANWORTH, FELTHAM, MIDDLESEX, TW13 5JH
Tel. 020 8894 9001 enquiries@swmcrematorium.gov.uk

For office use Receipt:	Date:
Plaque ordered:	Location:
Date fixed	ID Number

Terms and Conditions

1. Lead times for all memorials is 10 weeks

2. The Board will maintain all plaques for the lease period.

3. At the expiration of the lease period and subject to there being no agreement for renewal of the arrangements between the Board and the applicant (or anyone acting on their behalf), the Board may remove the plaque from the garden and the dedication shall cease.

4. For the purposes of the foregoing arrangements, the initial period of the lease shall commence on the date the memorial plaque is erected and expire at the end of the month on the fifth anniversary of that date.

5. To protect the integrity of the gardens no additional items are permitted to be fixed to the plaque, unless approved by the Board.

6. A reminder will be sent to the applicant approximately one month in advance of the expiry date to enable renewal of the lease.

7. When the lease period has expired, the plaque may be collected from the Crematorium by the applicant (or an assigned person). If the plaque is not collected within 6 months of the expiry date, the Board reserves the right to destroy the plaque.

Rose Bushes

8. The rose bush shall remain the property of the Crematorium Board, and they may replace the rose bush, if necessary (because of disease, wind damage etc.) at any time during the period, with one of the same type or alternative variety.

Benches

9. The bench remains the property of the Crematorium Board.

The bench will be maintained by the Crematorium, including cleaning and treatment as required (normally every 3rd year)

The bench must remain in the position indicated on the plan.

All benches must be left free of any attachments and must not be used as plant supports