Prearrangement Form

One of the advantages of prearranging your own funeral is that it plans for your final wishes prior to the time of need. This removes a huge burden from your family when you take care of the necessary funeral details and you provide all the information that we need. The following form allows you to send us the information we need to complete your prearrangements.

Applicant Info

Last Name: ^*

First/Given Name(s): ^*

Social Insurance Number:

Gender:

M: F:

Date of Birth:

Place of Birth:

Marital Status:

Name of Spouse/Partner:

Industry:

Work:

Applicant Residence:

Father - Name and Place of Birth:

Mother - Name and Place of Birth:

Is a pacemaker used?

Informant Info

Name:

Relationship to Applicant:

Address:

Telephone Number: ^*

E-mail Address:

Are you the Executor?

Yes No

Have the near Relatives and the Executer, if any, of the deceased been informed of the proposed cremation?

Yes No

Has any concerned person expressed any objection to the preposed cremation?

Yes No

Once you submit your information a funeral director will call or email you within 24 hours to confirm and make arrangements to sign contract.