Application for Certificate of Right of Inurnment

In this first section, please fill out the information of the applicant (holder). Please complete a separate application for each niche being requested.

Your name *

Email address *

Phone number *

Address *

Eligible Person(s) to be Inurned

In this section, please fill out the information for the person(s) to be inurned. Please enter names as you want them to appear. If the address is the same as the applicant (holder), you may leave that field blank.

Name of Person One *

Address of Person One (If Different from Above)

Relationship to Applicant (Holder) *

Name of Person Two

Address of Person Two (If Different from Above)

Relationship to Applicant (Holder)

Terms of Purchase

I acknowledge that my application is not complete until full payment is received. *

The church office will be in touch regarding payment options.

Acknowledgement of Rules and Regulations *

The Applicant agrees that the Rules and Regulations governing operation of the Ossuarium as now existing or which may exist in the future are a part of this application for all purposes, and acknowledges receipt of a copy of the existing Rules and Regulations. Specifically the Applicant acknowledges that person(s) named above are eligible for inurnment.

Signature *

Please enter applicant (holder) full name as signature.

Today's Date *

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.