Request for an inclusion of a name

Please submit this form to have a person's name read out and a candle lit during this service by Friday 30th October 2020


Name of the person making this application:*
email of the person making this application:*
Phone number of the person making this application:*
Name of the person whose name is to be read out and a candle lit:*
Name of the person whose name is to be read out and a candle lit:
Name of the person whose name is to be read out and a candle lit:
Name of the person whose name is to be read out and a candle lit:
Name of the person whose name is to be read out and a candle lit:
Name of the person whose name is to be read out and a candle lit:
Will you be attending the service in person?:*
Name of a person attending with you:
Name of a person attending with you:
Name of a person attending with you:
Name of a person attending with you:
Name of a person attending with you:
Name of a person attending with you:
Please list any disability requirements (eg wheelchair user or hard of hearing):
Please tick the box if you wish for your loved ones to be remembered in future years (and give us permission to retain your contact details for this purpose):
I would like these people remembered in future years and give my permission for Martham Parish Churches to retain my contact details for this purpose
Please enter the verification number on the right:*
one four six three two
* Required Fields