APPLICATION FOR INURNMENT

I __________________________ residing at ___________________________

___________________________ With a telephone number of ___________ do
hereby apply for my remains to be inurned in the Columbarium at Trinity
Presbyterian Church (USA) ("Trinity").

I am (check applicable box):

____A current member of Trinity.

____A past member of Trinity.

____A member of my family is a member of Trinity. The family member is

______________________________________________________________.

My relationship to that person is: ________________________________(describe
relationship).

____A member of the Presbyterian Church (USA) who has close ties with Trinity.

____Other: ______________________________________________________________

_______________________________________________________________ (describe).

Within 10 days of acceptance of your application you will be obligated to pay
$_____________ which is the full price for reserving your space in the
Columbarium.

I agree that my application is not final, and that I have no right to have a space
reserved for me in the Trinity Columbarium until this application is accepted by the
Columbarium Committee and I have paid the entire amount due and owing for my
space in the Columbarium.

I also agree that this application and my rights to my space in the Trinity
Columbarium are subject to and governed by the Policies, Rules and Regulations
Governing the Trinity Columbarium, a copy of which I have received and read.

_____________________________                            ________________
Sign                                                                               Date

Requesting Niche # __________
11/1/00 REVISION