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Online Form - Application To Hold a Funeral

Burial Details

Cemetery *

Religion *

Section *

Roman Catholic
Other Denomination
Muslim

Plot No *

Date of Funeral *

Time of Funeral *

Other Details *

Details About Deceased

Surname *

First Name(s) *

Last Residential Address *

Postcode *

Personal Details *

Male
Female

Birth Place of Deceased *

Date of Birth *

Date of Death *

Age of Deceased *

Place of Death *

Applicant Details

Title *

MrMrsMsDr

Surname *

First Name(s) *

Postal Address *

Postcode *

Relationship to Deceased *

Email Address *

Home Phone Number *

Work Phone Number *

Mobile Phone Number *

Full name of applicant *

Date *

Funeral Director Details

Title *

MrMrsMsDr

Surname *

First Name(s) *

Name of Funeral Home *

Postal Address *

Postcode *

Email Address

Home Phone Number

Work Phone Number

Mobile Phone Number

Nam of Minister to Officiate at grave *

Full name *

Date *

Dinemsions

Width of Coffin *

Length of Coffin *

Depth of Grave *

Size of Ground *

Backfill *

CouncilFamily

Please attach a copy of Death Certificate or Coroner’s Report when lodging this form *

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