Funeral ListingsContact Us
Search Site    
 
PRE-ARRANGE ONLINE FORM

One of the most caring things you can do for your family is to leave detailed information about your preferences for a funeral service.

Making funeral arrangements at the time of loss is extremely difficult for those left behind. When the funeral and the costs have been arranged in advance, your loved ones are not forced to make decisions at such a confusing time.  It’s best to plan ahead, calmly and sensibly, when you have the ability to reason and discuss arrangements with your family.

You may file vital statistics and preferred funeral information with us on-line by filling in the form below.

I. Biographical Information
Full Name:
Address1:
Address2:
City Name:
Province:
Postal Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
Province of Birth:
Social Insurance Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded You In Death
Your Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:
II. Military Record
Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (month/day/year)
Date of Discharge: (month/day/year)
Rank at Discharge:
Location of a Copy of Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:
III. Service Preferences
Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

Miscellaneous Notes and Instructions:


Please select one of the options below:

Please send me information on funeral planning

Please contact me to schedule an appointment

Please place my information on file
Admin | Privacy Policy | Site Map | Matthews IMS 4.0 | Powered by FrontRunner