Book of Remembrance App. | Loughborough University & Colleges - Chaplaincy

Garden of Remembrance / Book of Remembrance

No Charge is made for inclusion in the Book of Remembrance or for plaques.
Gifts to support the upkeep and enhancement of the Garden are welcomed.

Mandatory *

Donation for upkeep and development of the Garden of Remembrance *

Field not valid (required or bad value)

Commemorated Name *

Field not valid (required or bad value)

Role at University * eg Student, Technician, Lecturer

Field not valid (required or bad value)

Department at University * eg Mechanical Engineering

Field not valid (required or bad value)

Dates at University * Date Format: dd/mm/yyyy - dd/mm/yyyy

Field not valid (required or bad value)

Date of Death * and age at death if required

Field not valid (required or bad value)

Your Name *

Field not valid (required or bad value)

Your Address *

Field not valid (required or bad value)

Contact Telephone *

Field not valid (required or bad value)

Email Address Optional

Field not valid (required or bad value)

Relationship to the deceased *

Field not valid (required or bad value)

Next of Kin Name(s) if applicable

Next of Kin Address(s) if applicable

Next of Kin Contact Details if applicable

Data Protection Act A record of my name, address and order may be held by the university for administrative purposes.

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