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Pre-Arranged Funerals

To make an initial plan, complete the information in the area to the right.

Fill in as much as you can and then click on the 'send' button and we will then contact you to confirm your request and then provide you with a copy of the plan.

Pre-Paid option

If you would also like to pre-pay the associated costs we will discuss this with you when we contact you. Please tick the box at the end of the form.

Use of information

The information you provide will only be used to complete a pre-arranged funeral plan and optionally a pre-paid funeral plan. If you do not proceed with either we will destroy the information you have provided.
My Plan Information
My Own Details:
Name:
Address:
Phone:
email:        Required
  
Date of birth:
Place of birth:
Arrived in Australia:
Occupation:
  
Receive a pension?:
Yes: 
No: 
  
Father's Details:
Given Name:
Surname:
Occupation:
  
Mother's Details:
Given Name:
Maiden:
Occupation:
  
Marriage status:
 Not Married:   Married     Widowed 
 Seperated:     Divorced   Defacto   
  
1st Marriage Details:
Spouse given names: 
Spouse maiden:
Marriage location:
Date of marriage:
  
2nd Marriage Details:
Spouse given names: 
Spouse maiden:
Marriage location:
Date of marriage:
  
3rd Marriage Details:
Spouse given names: 
Spouse maiden:
Marriage location:
Date of marriage:
  
Children's Details: (oldest to youngest)
Name:
Date of birth:  Male:  Female   Dec: 
Name:
Date of birth:  Male:  Female   Dec: 
Name:
Date of birth:  Male:  Female   Dec: 
Name:
Date of birth:  Male:  Female   Dec: 
Name:
Date of birth:  Male:  Female   Dec: 
Name:
Date of birth:  Male:  Female   Dec: 
  
Funeral Service Details:
Venue:
Clergy/Celebrant:
  
Crematorium/Cemetery Details:
Choose:Cremation:   or Burial: 
Crematorium/
Cemetery:
Pre-purchased?:Yes:  
 Section/area:  
 Garden/row:
 Plot:
 No:   
Ashes disposal:
  
Pre-Paid Funeral Option:
I am interestd in discussing 'Pre-paying' my funeral expenses: 
  
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