Online Pre-Arrangement Form

Spouse's Information

Spouse's Name:

Spouse's Maiden Name:

Spouse's Address

Address:

 

City:

Country:

State/Province:

Zip/Postal code:

Legal Marital Status*:

Father & Mother Information

Father's Name:

Father's City of Birth:

Mother's Name:

Mother's Maiden Name:

Mother's City of Birth:

Work & Education

What is/was Your Occupation:

Kind of Business:

Company Name::

Military Information

Branch of Service:

Select One Royal Canadian Navy Canadian Army Royal Canadian Air Force

Funeral Service Information

Place of Service:

Select One Funeral Home Church Cemetery Other

I Prefer the Funeral Service to be:

 Public

 Private

Viewing for Family:

 Yes

 No

Viewing for Friends:

 Yes

 No

Religious Denomination:

Place of Worship:

Disposition Information

I Prefer:

Select One Burial Cremation Entombment

Cemetery:

Address:

Phone:

I Have Made A Last Will & Testament:

 Yes

 No

Additional Information

Flower Preference:

Music Selections:

Casket Pallbearers:

Jewelery:

Clothing:

Register Book and Memorial Cards:

Special Instructions

Other Information:

Memorials & Charities:

Send Information

Please Select One of the Options Below:

Select One Send Information About Pre-Need Contact to Set an Appointment Please keep my information on file