REQUEST FOR MEMORIAL PATH RESERVATON

MEMORIAL PATH RESERVATION REQUEST

I am a church member (or family member of a church member) and wish to make a reservation in Memorial Path. This reservation will allow for the burial of one urn of cremated remains (or the uncontainerized cremated remains) in Memorial Path of Wellesley Congregational Church Cemetery, along with a space reserved on the headstone designated below for inscription of the name, year of birth and year of death. The burial location within Memorial Path will be in a specific location determined by the Churchyard Committee upon the Individual’s death prior to interment.

Individual completing this form

Full name and contact information of Individual for which reservation is being made (no initials here please)

First Name

Middle Name(s), no initials

Last Name

Street Address, including unit #

Home Phone

Cell Phone

This address will receive a confirmation email

Reservation Type (Shared vs. Unshared; Intent in terms of burial of ashes)

A shared reservation is important if the individual is: a) interested in having his or her ashes interred in a burial location in Memorial Path; and b) has a designated individual with which he or she would like his or her ashes buried in the same burial location in Memorial Path.

Please choose one of the following two options:

SHARED RESERVATION – I wish to have my ashes buried in Memorial Path with someone else. UNSHARED RESERVATION – I wish to have my ashes buried in Memorial Path but I am not requesting that my ashes be buried in the same location as those of anyone else.

If you chose SHARED RESERVATION above, please type full name below – no initials here please.

I wish to share my reservation with:

Check here if... I DO NOT INTEND TO HAVE MY ASHES BURIED/INTERRED in Memorial Path.

HEADSTONE AND ENGRAVING INFORMATION:

When I would like to have an engraving done:

I am NOT READY to have my engraving scheduled at this time. I’ll decide and communicate this later or my wishes will be communicated by my loved ones, who will handle this upon my death. No payment is due at this time, only when I am requesting an engravi I would like to have my headstone engraved AT THE NEXT ENGRAVING (Spring or Fall).

If you selected the next engraving option above: I agree to pay for all engraving costs prior to the scheduling of an engraving.

All engraving costs include those related to the year of birth, name and year of death despite what will actually be engraved on the next scheduled date. Engraving costs are separate from the Memorial Path reservation fee. I choose to have the following engraved. Select engraving option:

Select Engraving Option

NAME TO BE USED FOR HEADSTONE ENGRAVING

• Engraving will be done in ALL CAPITAL LETTERS.

• Initials are allowed here.

• Professional titles or descriptors are NOT used for Memorial Path headstone engraving, e.g. Dr., Rev., Mr., Ms., Esq., etc.).

• There is limited space for engraving. Please keep to letters to 23 or fewer.

• Date of birth is requested for identification purposes though year of birth will be engraved

FIRST NAME MIDDLE NAME(S) LAST NAME

Date of Birth

ALTERNATIVE CONTACTS

First Name

Middle Name or initial

Last Name

Address (including unit #)

Home Phone

Cell Phone

Relationship

Additional Alternate Contacts

First Name

Middle Name or initial

Last Name

Address (including unit #)

Home Phone

Cell Phone

Relationship

Next Steps:

This request will be reviewed as soon as possible to confirm the completeness and accuracy. Following this, an invoice will be sent to you for payment. Full instructions will accompany the invoice in terms of where to send payment. Upon receipt of the amount due a Certificate of Reservation will be sent to you for your files. A file will be kept at Wellesley Congregational Church as well. Any questions, please call or email Meg Sweeting (781-235-1988, meg@wellesleyvillagechurch.org).

REQUEST FOR MEMORIAL PATH RESERVATON

Description

Please Fix the Following