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Plaque

Plaque options and inscription

Type of plaque

Text only

Text and motif

Text and photograph

Choose a motif

ABC blocks

Fairy

Teddy

Girl angel

Boy angel

Upload the photograph

If the image contains multiple people or items and you have not been able to edit the photograph, please tell us which part of the photo you want to display. (optional)

For example, ‘child on the right to be used'

Inscription text

Enter the text for the wall plaque below. You can include up to 85 characters, which must include the name of deceased. Please check your inscription carefully as mistakes cannot be rectified.

Inscription text

Enter the text for the wall plaque below. You can include up to 60 characters, which must include the name of deceased. Please check your inscription carefully as mistakes cannot be rectified.

Applicant details

Details of person completing this application

Title (Mr, Mrs...)

First name

Last name

Address

Postcode

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Phone

Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page

Request a memorial wall plaque at Springwood Baby Garden

Plaque

Plaque options and inscription

Applicant details

Details of person completing this application