Mortuary List 2023
INSTRUCTIONS:
Please enter the names of the loved ones you would like remembered on the Mortuary List.
You can enter up to 10 names. If you need to add more than 10 names, please complete another form.

There are 3 parts to this form:
Part A: Your Contact Details
Part B: Persons for the Mortuary List
Part C: Special Instructions and Comments

PART A: YOUR CONTACT DETAILS
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Email *
First Name: *
Contact Phone Number: (enter numbers only - no blanks) *
Surname: *
Email: *
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