NOTICE OF DEATH

Deceased Details
Full Name:
Age Last Birthday:
Gender:
Date of Birth:
Date of Death:
Address of the Deceased
(including postcode):
Place were death occurred (home/hospital):
Place of Burial (city/town):

Next of Kin Details
Relationship:
Full Name:
Address (including postcode):
Mobile:
Home Tel:
Email Address:

Second Contact
Name:
Relationship:
Mobile:

Terms and Conditions
http://masjidenoor.org.uk/gmbc/cemetery-rules.pdf
I hereby agree and abide by the rules and regulation of the Gloucester City Council & Cemetery / Cheltenham Borough Council & Cemetery.
Burial Charges
I agree to pay in full, the full cost of Disbursement and expenditure towards Funeral and Burial cost to the GMBC (Gloucester Muslim Welfare Association).