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Barnham Broom and Upper Yare Benefice

Funeral Enquiry

Please complete this form to enquire about holding a funeral in one of our Benefice churches. We will respond to you as soon as possible after notification of receipt. Alternatively please contact the Rector directly on 01362 858021 

*Mandatory Fields
  

Details of deceased person

*Name of deceased:
*Date of birth:
Home address:
Place and cause of death:

Service Details

Proposed date of funeral:
Proposed date of burial of ashes (if required):
Proposed time of funeral:
Please indicate the type of service required
Other information:

Details of Enquirer
*First name:
*Surname:
*Email address:
Address:
Town:
Postcode:
Home phone:
Mobile:
Relationship to deceased:
       I agree with the consent statement

Funeral Directors (details)

Name of company:
Phone number
 
 
 
 
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