Preplanning Form For more information about preplanning, be sure to read our preplanning page. Fields marked with an * are required HTML Information about who is completing the form: First Name * Last Name * Email * Phone * Address * City * Province * select province Alberta BC Manitoba New Brunswick Newfoundland & Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code * I am planning for * please select Myself Spouse Life partner Mother Father Child Sibling Friend Other Divider HTML Information about the person you are planning for First Name * Last Name * Middle Name Gender * select gender Male Female Date of Birth * Place of birth Marital Status * Never married select marital status Married Widowed Divorced Separated Common law Marriage Date Social Insurance Number Health Card Number Spouse's Full Name Maiden Name Father's Full Name Father's Place of Birth Mother's Full Name Mother's Place of Birth Divider HTML Work History Usual Occupation (most of life) Type Of Business Divider HTML Funeral Service Information Service Preference select service preference No service Graveside service Traditional service Cremation service Memorial service Place of Service Place Of Viewing / Prayers Disposition Options please select Casket burial Cremation Cemetery Divider HTML Person to finalize arrangements at time of death Is this information the same as the person's filling out this form? Yes, it is the same No, it is not the same Divider HTML Other information and special instructions Please list any other instruction or information you would like us to have Please Select: Contact me to set an appointment to discuss options with Dalmeny Funeral Home Staff Contact me to set up appointment to prepay funeral expenses Please keep my information on file If you are a human seeing this field, please leave it empty.
