Pre-planning

Setting the arrangements in place now means that you have the opportunity to shape your funeral so that you get the celebration you want.

Please complete the following form to provide us with information about the options you would prefer. Gary will be in touch to discuss this further.

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About You...

Your Name*

Full Name at Birth

Your Email*

Phone number*

Date of Birth

Place of Birth

Occupation

Years living in NZ

Street address

Address 2

City

Region

Postcode

Country

Ethnic Group

Descended from NZ Maori?

YesNo

Your Doctor's Name