Prearrangement Preference Form

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Personal Information Register
Prearrangement Preference Form

Contact Information
If you are filling this form out for someone other than yourself , provide the following contact information. If you are filling this form out for yourself move to the next section NOTE: if you use your back button you will lose your information!
Full Name	Relationship to Individual
Address Line 1
Address Line 2
City
Province	Postal Code
Telephone	Email
Prearrangement Contact Information
First Name	Middle Name
Last Name
Address Line 1
Address Line 2
City
Province	Postal Code
Telephone	Email
Date of Birth	Birthplace (City, Province, Country)
Sex Male Female	Marital Status
Maiden Surname (if applicable)	Spouse/Partner's Name
Occupation	Type of Industry
Father's Name (First, Middle, Surname)	Father's Birthplace (City, Province, Country)
Mother's Name (First, Middle, Surname)	Mother's Birthplace (City, Province, Country)
Armed Forces Record
Service Number	Unit
Rank	Date of Discharge
General Information
Memberships	Fraternal Associations
Location of Will
Executor/Estate Trustees (Name, Address, Phone Numbers)	Executor/Estate Trustees (Name, Address, Phone Numbers)
Church	Clergyman (Name and Phone Number)
Funeral Arrangements
Funeral Home	Visitation: Public Private
Choose: Burial Cremation Entombment	Casket to be: Open Closed
Casket Preference: Metal Hardwood Fabric Covered	Casket Model # View Casket Selection here
Include the Following: LifeSymbols Corners LifeSymbols Keepsake Plaque MemorySafe Drawer Memorial Record Tube Memorial Record Parchment	LifeSymbols Model: View LifeSymbols Corners here Learn about LifeSymbols here
Outer Container (vault) for Burial: Yes No	Vault Model # View Vault Selection here
Urn for Cremated Remains: Yes No	Urn Model # View Urn Selection here
Service: Public Private	Location: Church Funeral Chapel Other If Other, please specify:
Pallbearers:	Honorary Pallbearers:
Music	Flowers
Memorials
Special Instructions (Clothing, jewellery, donations, soloist, piper, bugler, flag, post-funeral reception, police escort, press notices, limousines, prayer cards, quotes, bible passages, etc)
Cemetery Arrangements
Name of Cemetery	Phone Number
Cemetery Address	City
Province	Postal Code
Location of Deed	Plot in Name of:
Section
Plot Number	Block

Thank you! Someone from Watt's Funeral Home will contact you to confirm your choices and answer any questions you may have.

Watts Funeral Home
132 River Road East, Wasaga Beach, Ontario, Canada
Inquiries@wattsfunerals.com

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Armed Forces Record

General Information

Funeral Arrangements

Cemetery Arrangements