Funeral Director Application Form

On receipt of this Application Form we will send you the Terms and Conditions for joining the Simple Funeral network. All applications will be dealt with in confidence.

Please complete one Application Form for each branch office.

Name of Company/Branch: _____________________________________________________________

Address 1: _________________________________________________________________________

Address 2: _________________________________________________________________________

Address 3: _________________________________________________________________________

Town/City: ________________________ County: ______________________ Post Code: ___________

Name of Contact: Mr/Mrs/Miss (Please delete as appropriate)

First Name: ____________________________ Surname: _____________________________________

Position in Company: __________________________________________________________________

Telephone No (24 hours): STD ________   _______________   Fax: STD _______   _________________

E-mail (if applicable): __________________________@________________________________________

Website (if applicable): www.______________________________________________________________

Name of the ultimate owner of the Company if different from above:

__________________________________________________________________________________

Member of which organisations (if any): NAFD, SAIF (Circle which)

There may be certain requirements specific to each funeral. Please indicate below what service you can offer:

   One Funeral Director
   Refrigeration Facilities
   Viewing Rooms
   One or more limousines

   Two or more Funeral Directors
   Embalming Facilities
   Hearse
   Accept payment using Visa, Access, Switch etc

Please send completed application form to:

"Confidential"
Mr R.J. Morphet
470 Great Horton Road,
Bradford,
BD7 3HR

Please ensure an original letterhead/compliment slip accompanies each application form

Your Signature __________________________________    Date _______________________________