Start Your Own Plan

If you are in the position where you would now like to start your own Funeral Plan then please call us on 01604 792222 to make an appointment.

To aid the process, please use this form to gather your thoughts about your desired funeral service before you meet with us. You can print it for your own records, and submit it online for our attention.






Your Name (required)

Your Email (required)

Your Address (required)

Your Phone Number (required)

Your Occupation (required)

Your Martial Status (required)

Your Date of Birth (required)

Your Place of Birth (required)

Next of Kin (required)

Next of Kin Address ( required)

Next of Kin Telephone Number (required)

Your Relation to Next of Kin (required)

Location of Will and other information (required)

Funeral Home (required)

Preference of Cremation or Burial (required)

Music and Hymns

Flowers (required)

Donations in Lieu of Flowers (required)

Charity/Charities

Would you like us to send you some information on pre-paid funeral plans? (required)

Would you like us to contact you to arrange an appointment? (required)

Would you like us to keep you information on file? (required)

Is there any additional information you would like us to know?

You can print a copy of this form for your own records if you wish. Please do this first before clicking the submit button to send the form to us. All data submitted is kept private and confidential.