Get a start on your preplanning

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

Name*
FirstLast
Address*
Street AddressCityProvincePostal Code
Date of Birth*
Place of Birth*
Age*
Moved From...
If applicable
Occupation
Or previous occupation prior to retiremnet
Social Insurance Number
This is needed for Canadian Pension Plan Benifeit
Spouse
Including maiden name if applicable
If Deceased (date)
Father's Name
Mother's Name
Including maiden name
Please Complete If You Are A Veteran
Branch of Service
Serial #
Rank
Date of Entry
Place of Entry
Place of Discharge
Memberships
Please List Membership: Examples: Church, Fraternal, Civic, Service Group, Etc...
Survivors
Please List Names, Relationship & Residence
Example Children John and Jane Doe of Exeter (519-235-1220) Sally and Bob Doe of Lucan (519-227-2411)
Service Information
Choice of Dispostion
Where Would You Like The Service To Be Held?
Funeral Home, Church, Residence...
Where is your Cemetery Property?
Musical Preferences
Pallbearers or Urnbearer
We would suggest 6 male or female able body individuals.
Memorial Contributions (Donations)
Information On Person Responsible/Executor
Name
FirstLast
Address
Street AddressCityProvincePostal Code
Email
Phone

Please Complete If You Are A Veteran