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Cemetery Work Request Form
Forms
April 27, 2016
This form must be on file with the City of De Leon, before any working can take place at the the De Leon Cemetery or the Garden of Memory Cemetery.
Select a cemetery
*
Required
De Leon Cemetery
Garden of Memory Cemetery
Name
*
Required
First
Last
Requesting to start work on
- must be mm/dd/yyyy format
*
Required
Date Format: MM slash DD slash YYYY
Nature of work
*
Required
Location site
*
Required
Name of worker
*
Required
First
Last
Address of worker
*
Required
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Contact number for worker
*
Required
Funeral Home Information
Funeral Director
*
Required
First
Last
Deceased name
*
Required
First
Last
Date of birth of the deceased
- must be mm/dd/yyyy format
*
Required
Date Format: MM slash DD slash YYYY
Date of deceased
- must be mm/dd/yyyy format
*
Required
Date Format: MM slash DD slash YYYY
Date of service
- must be mm/dd/yyyy format
*
Required
Date Format: MM slash DD slash YYYY
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