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* First Last Email* Enter Email Confirm Email Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Date of Birth*Place of Birth*Age*Moved From...If applicable OccupationOr previous occupation prior to retiremnet Social Insurance NumberThis is needed for Canadian Pension Plan Benifeit SpouseIncluding maiden name if applicable If Deceased (date)Father's NameMother's NameIncluding maiden namePlease Complete If You Are A VeteranBranch of ServiceSerial #RankDate of EntryPlace of EntryPlace of DischargeMembershipsPlease List Membership: Examples: Church, Fraternal, Civic, Service Group, Etc...SurvivorsPlease List Names, Relationship & ResidenceExample Children John and Jane Doe of Exeter (519-235-1220) Sally and Bob Doe of Lucan (519-227-2411)Service InformationChoice of DispostionBurial in a cemeteryCremation with interment in a cemeteryCremation without cemetery intermentWhere Would You Like The Service To Be Held?Funeral Home, Church, Residence... Where is your Cemetery Property?Musical PreferencesPallbearers or UrnbearerWe would suggest 6 male or female able body individuals. Memorial Contributions (Donations)Information On Person Responsible/ExecutorName First Last Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Email PhoneCommentsThis field is for validation purposes and should be left unchanged.
