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Particulars For Inscription In Book Of Remembrance

Complete this form if you wish to have an entry put in the Book of Remembrance at Gornal Wood or Stourbridge crematorium.

Stourbridge Crematorium only. Badges and crests are only available in the book of remembrance at this crematorium.  They are not available in the book at Gornal Wood.  If you require a badge with your entry for the book of Remembrance then you will need to contact the Stourbridge office to discuss your requirements.

Bereavements Services Manager,
Stourbridge Crematorium,
South Road,
West Midlands,
DY8 3RQ.
Tel: 01384 813985

Inscription in Book of Remembrance held at *
Inscription in Book of Remembrance held at

Data Protection Statement

The information you provide on this form is subject to the provision of the Data Protection Act 1998. The information will be held confidentially and will be retained for the purposes of processing your request, providing feedback where appropriate, managing Cemeteries and Crematoria and meeting our statutory obligations.

Your information will not be shared with anyone else. Further details on how your information will be used can be obtained by contacting the Bereavement Services Manager on 01384 823970.

Please refer to our Privacy & Disclaimer Statement below for our Information Charter and general information on our approach to security, confidentiality, data collection, etc.

Further data protection information can be obtained from the Information Commissioner's website at

Online payment

This service requires an online payment; you will be taken to the secure payment facility upon submission of this form.

  • You need a valid debit or credit card.
  • Your application will not be processed until payment has been received
  • Inscription fee: 2 lines - £88.00; 5 lines - £124.00; 8 lines - £156.00
    Memorial card fee: 2 lines - £59.00 each; 5 lines - £81.00 each; 8 lines - £100.00 each
  • The online payment facility is not available from 7:45 pm to 8:15 pm, Monday to Saturday.
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