Burial Request Form - Municipality of Northern Bruce Peninsula

Required fields are marked with asterisks (*)

Municipal Burial Request Form	56 Lindsay Road 5 Lion's Head, ON N0H 1W0 Phone: 1-833-793-3537

Date:

Contact Name:

Email Address:

Phone Number:

Name of Deceased:

Date of Birth:

Date of Death:

Which municipal cemetery?

Dunk's Bay Cemetery

Eastnor Cemetery

Stokes Bay Cemetery

Plot Number:

*Burial hours are Monday - Saturday from 11:00 a.m. - 3:00 p.m. and Saturday Statutory Holiday burials are subject to an increased fee.

Preferred Burial Date:

Preferred Burial Time:

Burial Date Type:

Weekday Burial

Saturday/Statutory Holiday

*Cremation openings are 2' x 2' - please indicate if oversized.

Burial Type:

Casket

Cremation Urn Single

Cremation Urn Double

Columbarium Niche

Special Requests:

Municipal Burial Request Form