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Personalizing
What
Your Family
Should Know
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Your family should know the following information so they
can best carry out your wishes and instructions.
It may be helpful to write this information down and
store it in a safe, easily accessible place that your family
is aware of.
For your convenience and to assist you in planning for
your needs we have included the following information in
an easy to fill out blank form. (adobe reader pdf format)
You will need adobe reader in order to view or print the
form. If you do not have adobe reader you may acquire it
for free by clicking Here.
Simply fill out the form and store it in a safe easily accessible
place.
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My Wishes
and Instructions & Vital Information Form
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| Vital Statistics: |
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Name
in Full |
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Address |
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Date
of Birth |
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Social
Insurance Number |
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Occupation |
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Marital
Status |
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Partner's
Name in Full |
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Father's
Name in Full |
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Father's
Birthplace (Town, Province or Country) |
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Mother's
Name in Full (Maiden Name) |
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Mother's
Birthplace (Town, Province or Country) |
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Next
of Kin (Name and Address) |
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| Instructions Concerning My Funeral: |
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Name
of Funeral Home |
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Service
to be held in Funeral Home Chapel
or Other Location |
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Clergy
Person |
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Pallbearers |
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Music |
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Memberships/Fraternal
Associations |
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| Disposition
Wishes:
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- Name
and Location of Cemetery
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- Location
within Cemetery (Section,
Lot
, Grave)
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- Method
of Disposition for Cremated
Remains (Earth
Burial, Niche Burial, Other)
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| Additional
Wishes:
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- Additional
Wishes or Instructions
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