Application for a Reservation of a Grave Site at the Congregation B'nai Zion Cemetery in Key West, FL

I, _______________________________________________________, member(s)

in good standing of Congregation B'nai Zion Key West, FL, with our/my membership dues currently paid up to date,

request (number)______________ reservation(s) for Grave Site(s) at the CBZ Cemetery in Key West, FL

Please list the Names for the Grave Site Reservations

1. _____________________________________________ Phone _____________________________

2. _____________________________________________ Phone _____________________________

3. _____________________________________________ Phone _____________________________

Emergency Contact 1 Name_____________________________Relationship _______________________

Phone H___________________ Phone Cell________________E-Mail___________________________

Emergency Contact 2 Name_____________________________Relationship_______________________

Phone H___________________ Phone Cell________________E-Mail___________________________

My Burial Plans include (a) Full Body Burial ______________or (b) Cremation _______________

Reservations for Grave Sites in the CBZ Cemetery KW cost $350.00 each.

A Perpetual Care Fee of $1,000.00 per Grave Site must be paid with this application.

The final cost of the grave site is determined by the length of membership at Congregation B'nai Zion.

What year did you join CBZ________________________

Total Amount Pd___________________Check Number_______________Check Date________________

Please make your Check out to Congregation B'nai Zion...memo line - CemeteryRes/PerpCare

Please mail to Congregation B'nai Zion, 750 United Street, Key West, FL 33040