Sample Completed Recording Form

Sample Completed Recording Form

Section One - Cover Page

Please complete this page in black pen, preferably using capitals

Church details

1. Name of Church / St Martin, Oldbury
2.  Owner
(*delete as appropriate) / Church of England/Church in Wales/Other (please specify):*
3. Parish /

Oldbury and Eastford

4. County / Wessex / 5. Local Authority / Newbridge DC
6. National grid reference / NG12345678
7. Number of ledgerstones recorded / 3
8. Earliest and latest stone / 1624; 1712
9. Name of Recorder(s) / C Smith
M Turner
A Turner
11. Address
(of main contact if a group) / Mrs C Smith
The Old Bakery
Main Street
Oldbury
NEWBRIDGE
Wessex
12. Post Code / NB4 5XX
13. Telephone / 0111 123456 / 14. E-mail /
Church Contact (i.e. person to whom copy of report should be sent)
15. Name / Mrs A Jones
16. Address / Secretary, Oldbury and Eastford PCC
The Old Rectory
Oldbury
NEWBRIDGE Wessex
17. Post Code / NB4 5XY

Signed ____C Smith______Date ___10 Jan 2005______

Please complete one Title Page form for each church surveyed or, where submitting a partial record for each time sending a Report to the National Co-ordinator.

Section Two - Ledgerstone Report (please complete one record for each stone recorded)

1. Location of Ledger / South Aisle in aisle between pews. Level with westernmost window of south wall / 2. Plan no / 1
3. Other details / Charity Board in bell tower. Smith Educational Charity in memory of the late Emily Smith.
4. Number of people commemorated / 2
5. Name(s) of Person(s) commemorated / Arthur Smith
Emily Smith / 6. Year(s) of Death / 1624
1654
7. Description / 8. Measurements / Length: 68.5 in 1786 mm
Breadth: 32.75 in 830 mm
9. Materials / Black marble.
10. Heraldry / Engraved shield at head of stone
11. Imagery or decorative motifs / Garland or wreath at foot of stone
12. Condition / Good
13. Other notes / None
14. Inscription

Section Three - Church Floor Plan and Index of Ledgerstones

Church details

1. Name of Church / St Martin Oldbury
2. County / Wessex
3. National grid reference / NG12345678
Number / First Name on Stone / Location
1 / Arthur Smith / South Aisle in aisle between pews. In second bay from west end (tower) Level with westernmost window of south wall.