FORM B
/ APPLICATION TO APPLY FOR A DAC NOTIFICATION OF ADVICE FOR INSTALLATION OF A SEAT/BENCH IN A CHURCHYARD, BEFORE PROCEEDING TO FACULTY

Please confirm and answer in boxes provided. PRINT CLEARLY. Incomplete information may delay your application.

Petitioners details:
Name:
Address:
Post Code:
Tel No:
Mobile:
Email address:
NB: It is recommended that parishes have a written policyagreeing to amaximum number of seats/benches being installed into their churchyard.
Are you a member of the PCC?

YES: NO: / If noplease give details
(i.e. parishioner / relative to whom the memorial seat/bench is dedicated to?)
Parish of:
Church of:
Church grade listing:

III*IIUnlisted / Is the churchyard closed?

Yes: No:
Is the churchyard within the boundary of the church?

Yes: No: / If NO please confirm location of churchyard:
To allow the Committee to give full consideration to your application, the following information is to be submitted and/or confirmed.
1. / FORM 1A- Standard information (parish churches etc.) –This is a new provision under the Faculty Jurisdiction Rules 2013 and provides basic information about the church. This form is part of the application process, but once completed, can be retained by the parish and simply reprinted as required. It is recommended that the form should be checked before each subsequent DAC application, to ensure that all the information is still valid e.g. name of inspecting architect. The parish to include a copy of this document when submitting Petition for Faculty Form 3A or Form 15 to Diocesan Registrar, Minerva House, 5 Montague Close, London SE1 9BB. / FORM 1A included
YES
OR
FORM 1A has already been submitted with a previous application
YES
1. / I confirm the parish have/have not an agreed policy to a maximum number of seats/benches being installed in the churchyard: / Maximum number of seats/benches agreed
2. / I confirm the total number of seats/benches currently installed in the churchyard is: / Number of seats/benches already installed
3. / I confirm this application is for one seat/bench only:
(If more than one seat/bench to be installed, please state how many) / Tick this box to confirm
4. / I include a copy of PCC minutes agreeing to this application and confirm funds are in place to cover the cost: / Tick this box to confirm
5. / I confirm that no seat/bench will be purchased or a contractor instructed to proceed until a Faculty has been granted: / Tick this box to confirm
6. / I include photograph/s and churchyard plan of existing seats/benches in the churchyard: / Tick this box to confirm
7. / I include photograph/s and churchyard plan of proposed location of new seat/bench in relation to existing: / Tick this box to confirm
8. / I include design details and sizes of seat/bench from a catalogue or brochure, or drawings from craftsman appointed to construct the seat/bench: / Tick this box to confirm or name of contractors
9. / I confirm the seat/bench is from sustainable sourced timber/or an alternative material: / Confirm type of timber or alternative material
10. / I confirm that a treated timber seat/bench will be matt finished, not glossed: / Tick this box to confirm
11. / I confirm purchase price of seat/bench to be: / £
12. / I confirm there is no cost to the parish but donated by:
SEAT/BENCH FIXING DETAILS:
13. / I confirm the seat/bench will be fixed in accordance with DAC recommendations attached to this application form: / Tick this box to confirm
14. / If an alternate fixing method is proposed, please give details:
MEMORIAL DEDICATION DETAILS:
NB: Due to theft of metal the parish are to consider any memorial inscriptions being carved onto the seat/bench.
Carved dedication: / Location of carved dedication: (i.e. along top rail)
Plaque: If a plaque is the preferred choice, it is recommended to source a material which would weather well in all climate conditions so as not to wear away any dedication inscription:
(Brass plaques are not acceptable) / Bronze/Slate/Other - Please confirm colour of slate or other material:
Plaque size:
Plaque inscription details: / Font style:
Font size:
Fixing method:
Inscription wording: (please write clearly and use addition sheet if necessary)

Please Note: Onceyour application has been considered and recommended,a Notification of Advicewill beissued and returned to the contact name given at the beginning of this application form. Instructions and documents to proceed to Faculty will also accompany the Notification of Advice. The DAC Notification of Advicedoes not give you permission to install the seat/bench, permission is granted by the Chancellor or Archdeaconthrough the Diocesan Registry legalprocedure.