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(905) 892-5762
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1292 Pelham Street
P.O.Box 556
FONTHILL, ON L0S 1E0
(905) 892-5762
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Obituaries & Tributes

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Online Funeral Planning


I. Biographical Information
Full Name:
Date of Death:
Address1:
Address2:
City Name:
Province:
Postal Code:
Telephone Number:      (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
Province of Birth:
Highest Education Level:                  
Please select Grade/Years of Education completed:                  
   
Social Security Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:            
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence            
Relatives Who Have Preceded In Death            
Occupation:
Business Type:
Company Name:
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 (DD214):            
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences
Type of Service:
Visitation Hours:
Casket:
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

Please contact me to schedule an appointment

Please place my information on file

         

       

 

Proudly Serving Fonthill and the Surrounding Area

(905) 892-5762 1292 Pelham Street | FONTHILL, ON L0S 1E0 | Fax: (905) 892-4334 | Email: pedlarfh@cogeco.ca