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Rose Hill Cemetery Plot Application

2. Instructions
   Please complete this application to the best of your knowledge. Once submitted, the application will be reviewed and you will be contacted with purchase details and payment instructions.

   Please complete this application to the best of your knowledge. Once submitted, the application will be reviewed and you will be contacted with purchase details and payment instructions.

4. Applicant's Name*

6. Applicant's Address*

8. Applicant's Phone Number*

9. Email

11. Rights Holder's Name*

13. Rights Holder's Address*

15. Rights Holder's Phone Number*

16. Email

18. Parcel Intentions
    Limit of two (2) burials per Parcel

    Limit of two (2) burials per Parcel

20. Parcel Location

22. Block

23. Section

24. Lot

25. Space(s)

27. Rose Garden

29. Please check one

    1. Full Burial
    2. Cremains
    3. Unknown at this time (If Rights Holder chooses "unknown", only one burial will be allowed in this Parcel.)

31. Double Depth

    1. Yes
    2. No

    This option is reviewed by staff

33. Specific Instructions

    Please note any future burials, specific requests, parcel assignments, etcetera.

35. Please Note:
    I understand that any changes to the information provided herein, requires an updated Application Form.

    I understand that any changes to the information provided herein, requires an updated Application Form.

37. Signature*

    By typing your name in the field available, you are hereby authorizing the City of Spearfish, South Dakota to accept this as your electronic signature.

38. Date*
    Date

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field