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Online Form - Application For Memorial Works



Applicant Details


I hereby certify that I am authorized as/by the holder of the grant of right burial for the abovementioned grave to approve erection of the memorial detailed herein and I accept that the approval issued will be subject to conditions stipulated in the cemeteries act, the grant of right of burial and the by - Laws and regulation now and hereafter in force.

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Note: The Town of Port Hedland is indemnified against any liability attributed to any incorrect statements or information contained in this form.

Contractor Details

Information for this section should be provided by the contractor

Maximum size of ALL attachments is 976.56 MB

Type of Work

Type of Work*

Maximum size of ALL attachments is 976.56 MB

Please be advised that the contractor as well as the applicant will be notified whether the application has been approved or not, in writing within a period of 10 working days

Terms and Conditions

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