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The maximum number of form submissions has been reached. This form is currently not available.
Please complete all of the details requested below. Once submitted your request will be confirmed by either an or a phone.
Type of internment required
REQUIRED
If requesting the burial of cremated remains with a coffin burial please enter the details of the cremated remains seperately
(Select One)
Coffin Internment
Cremated Remains Internment
Please fill out this field.
Select the type of lair required...
REQUIRED
(Select One)
New Coffin Lair (New standard lair with capacity for 3 standard coffins & 4 cremated remains burials)
Reopen Lair for Coffin Burial (reopen within an existing standard lair that has been previously used)
Reserved Lair for Coffin Burial (within an unused reserved standard lair)
Garden of Remembrance New Cremated Remains Lair (Capacity 1 set of cremated remains)
Reopen Cremated Remains Lair (reopen within an existing standard lair that has been previously used or reserved lair)
New Cremated Remains Standard Lair (Capacity for 3 standard coffin burials & 4 sets of cremated remains)
New Cremated Remains Standard Lair (Capacity 8 sets of cremated remains - no coffin burials)
Please fill out this field.
If you have a deed for a lair please enter the details.
Deed - Please indicate your position
REQUIRED
I have the deed
I have lost the deed
I would like a replacement (£35 fee at the time of burial & £55 outwith a burial)
I would like a deed with a name change (£35 fee at the time of a burial & £55 any other time)
For New lair
Please fill out this field.
Add section & lair number for previously owned lair or add 'new lair'
Please enter valid data.
Name of last person interred
REQUIRED
Please fill out this field.
Please enter valid data.
Requested 'Date' of Internment (to be confirmed by cemetery)
REQUIRED
Requested date will be confirmed by the cemetery
Please fill out this field.
Please enter a date.
Requested 'Day' of Internment
REQUIRED
Requested the selected day...
Please fill out this field.
Please enter valid data.
Requested time of Internment (to be confirmed by cemetery)
REQUIRED
Requested time will be confirmed by the cemetery
Please fill out this field.
Please enter valid data.
Add outside dimensions of coffin (including handles)
Please enter valid data.
Name of Receiving Church or Parlour
REQUIRED
Please fill out this field.
Please enter valid data.
Details of the deceased
Name of Deceased
REQUIRED
Please fill out this field.
Please enter valid data.
Address of deceased
REQUIRED
Please fill out this field.
Please enter valid data.
Post Code
REQUIRED
Please fill out this field.
Please enter valid data.
Place of death
REQUIRED
Please fill out this field.
Please enter valid data.
Date deceased died
REQUIRED
Please fill out this field.
Please enter a date.
Age of deceased
REQUIRED
Please fill out this field.
Please enter valid data.
Funeral Directors details only
Name of Funeral Director
REQUIRED
Please fill out this field.
Please enter valid data.
Name of Director/Administrator arranging funeral
REQUIRED
Please fill out this field.
Please enter valid data.
Funeral Directors (address for invoice purposes)
REQUIRED
Please fill out this field.
Please enter valid data.
Funeral Directors contact number
REQUIRED
Please fill out this field.
Please enter valid data.
Funeral Directors email address
REQUIRED
Please fill out this field.
Please enter valid data.
Applicants details
For all applications including for a
new lair.
Name of applicant (person requesting the internment or new lair request)
REQUIRED
Please fill out this field.
Please enter valid data.
Address of applicant
REQUIRED
Please fill out this field.
Please enter valid data.
Post Code
REQUIRED
Please fill out this field.
Please enter valid data.
Contact number of applicant
REQUIRED
Please fill out this field.
Please enter valid data.
Legal Indemnity
(must be completed in all cases by the applicant)
Certify that I am (a), (b), (c), and that I have the legal right over this lair for this interment request. I take full responsibility for this request and all information hereby currently given & or any information given erroneously.
REQUIRED
(a) I am the title deed holder.
(b) I am the legal heir of the title deed holder.
(c) I am the representative of the title deed holder.
Please fill out this field.
I agree to St Conval's Terms & Conditions relating to my request for a burial with the cemetery.
Full name - I confirm this is my signature (applicant requesting the burial)
REQUIRED
Please fill out this field.
Please enter valid data.
By checking the box I accept the Terms & Conditions set by St Conval's Cemetery and the Diocese of Paisley Trustees. (Applicant to tick)
REQUIRED
Applicant, I agree
Please fill out this field.
Submit
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