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Application
Form

Application for a Bronze Memorial Wall Plaque (10 years) and/or Polished Granite Memorial Vase (10 years) and/or Memorial Tablet (15 years)

Please ensure that your inscription is clearly written in block capitals in the correct boxes below. Do not
forget to include the spaces in your inscription. A space counts as a letter or number. Salisbury City
Council reserves the right to refuse an entry which is considered unsuitable. Please refer to the enclosed
fees and charges sheet to confirm current costs.

DD dash MM dash YYYY

Memorial Type

Memorial Type
For memorial tablets, please indicate preferred inscription.

Tablet

Tablet

Inscription

Inscription

(Maximum number of characters/spaces is 16 per line, maximum 5 lines)