Pre-arrangement of Funeral Services

 

Pre-arrangement of Funeral Services

A copy of this form can be given to your solicitor with a further copy being given to The Lychway Funeral Directors to be kept in their company’s funeral pre-arrangement file.

Your name (required)

Your email (required)

Venue for Service

Burial or Cremation

Music/Hymns

Officiant/Celebrant

Flowers

Donations to

All deaths that occur in New Zealand are required to be registered at the Department of Internal Affairs. The following information is requested

Full name

Name at Birth (if different)

Address

Occupation

Date of Birth

Place of Birth

Ethnic Origin

War Service Number

War

Rank

Unit/Regiment

Father’s Full Name

Father’s Occupation

Mother’s Full Name

Mother’s Occupation

Mother’s Maiden Name

Spouse’s Full Name

Place of Marriage

Age at Marriage

Daughter’s Dates of Birth

Son’s Dates of Birth

Would you like us to contact you regarding this pre-arrangement?
Yes

Would you like further information regarding pre-paid funerals?
Yes