APPLICATION FOR AN ENTRY IN THE BOOK OF REMEMBRANCE
(Please write legibly and in block letters)
2. Please tick choice of book:
Rochdale Book of Remembrance
Middleton Book of Remembrance
Miniature Book of Remembrance
3. Note:- The name counts as and is charged for as one line. No more than 35 letters or
figures can be accommodated upon each line. Entries must consist of 2, 5 or 8 lines.
Surname and First
4. Please record in the Book of Remembrance the entry set out above (3) under the date
Please supply ……….. number of Memorial Cards in total.
Number of Type A Memorial Cards:
Number of Type B Memorial Cards:
Number of Type C Memorial Cards:
6. I enclose a: Cheque or Postal Order for £
Cheques and Postal Orders should be made payable to Rochdale Borough Council.
7. Please provide a telephone number