PRE-ARRANGE ONLINE FORM

One of the most caring, loving things you can do for your family is to leave detailed information which permits them to make the funeral service a personal tribute in keeping with the way you wanted.

Making funeral arrangements at the time of loss is extremely difficult for those left behind. When the funeral, and sometimes even payment, have been arranged in advance, most of the decisions have been made, sparing uncertainty and confusion at a time when emotional stress may make decisions difficult.

Would it be better in your situation to plan ahead, calmly and sensibly, when you are in a normal mental and physical state, when you have full ability to reason, and when you are able to discuss arrangements with your family?

You may file vital statistics and preferred funeral information with us on-line by filling in the form below.

And here is our promise to you: At no time will you receive or even sense any obligation or pressure from any of our people. We take great pride in our reputation - and ensuring that those who place their trust in our firm never question our loyalty or intentions in serving them and their loved ones.

The information provided is for use within the Greater Edmonton Area, inquires for information or services outside of the Edmonton Region should be made to a funeral home within in your own local area.

Thank You.

Pre-Arrange Online Form
* Denotes Required Fields  
  I. Biographical Information
*Your First Name:
*Your Last Name:
Suite:
*Address:
*City:
*Province:
*Postal Code:
*Country:
*E-mail Address:
*Phone:
Date of Birth: (month/day/year)
City of Birth:
Province of Birth:
Social Insurance Number: For security reasons, we will contact you to complete the pre-arrangement.
Father's First Name:
Father's Last Name:
Father's Birthplace:
Mother's First Name:
*Mother's MAIDEN Last Name:
Mother's Birthplace:
Marital Status:
Spouse's Name:
Spouse's Maiden Name:
Obituary Information (optional)      Name of survivors:
Relatives Who Have Preceded You In Death:
Occupation (during your working years):
Business Type:
Church Membership:
Lodge or Union Name:
  II. Military Record
Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (month/day/year)
Date of Discharge: (month/day/year)
Rank at Discharge:
Location of a Copy of Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:
  III. Service Preferences
Place of Service:
Church Name:
Other:
Casket:
Visitation Hours:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:
Miscellaneous Notes and Instructions:
Please select one of the options below:
Please send me information on funeral planning  
Please contact me to schedule an appointment
Please place my information on file
By submitting this form you are granting Connelly-McKinley Ltd. permission to send you information from time to time announcing upcoming Estate Planning Seminars and provide any new information as it becomes available. This will be strictly from Connelly-McKinley Ltd., and you are able to have your address removed from our records –at any time. We are not interested in mailing unwanted literature or spamming e-mail addresses. Connelly-McKinley Ltd. has a strict Privacy Policy and Practice in place – we will NEVER share your name and/or contact information outside of our firm.
This is our promise to you…



Company Intranet | Site Map

   
Copyright © 2005 Connelly-McKinley. All Rights Reserved.
  Web Design and Hosting by WebStorm