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Geelong, Bellarine and Surf Coast

24 hours, 7 Days: Office Hours: 9am-5pm (Mon-Fri)

1 Coppards Road, Newcomb, VIC 3219

(03) 5248 5500

108 Church Street, Hamlyn Heights, VIC 3215
(BY APPOINTMENT)

Your Service, Your Choices

Following a person's passing, there will be requisite

information required in any funeral arrangement.

Listed below are many necessary and obligatory details to be considered.

There are many decisions you'll encounter and some of these

can be overwhelming, but, we're always here to help.

Your Personal Details

Mrs

Miss

Other

First Name

Last Name

Also Known As

Phone

Address

Date Of Birth

Male

Female

Arrived in Australia (If Applicable)

Occupation (During Working Life)

Ex-Serviceperson

Yes

Service No.

RSL Sub-Branch

Masonic Lodge

Yes

Which Lodge?

Contact Number

Your Parent's Details

Father's Full Name

Father's Occupation (during working life)

Mother's Full Name

Mother's Maiden Name

Mother's Occupation (during working life)

Your Relationship Details

Married

Widow(er)

Divorced

Never Married

Defacto

Spouse Name

Spouse Name At Birth

Relationship

Date of Marriage

Place of Marriage

If you have had more than one relationship, please enter the details below.

Your Children's Details

Child 1

Given Name At Birth

Current Surname (If Applicable)

Date Of Birth

Male

Female

Child 2

Given Name At Birth

Current Surname (If Applicable)

Date Of Birth

Male

Female

Child 3

Given Name At Birth

Current Surname (If Applicable)

Date Of Birth

Male

Female

If you have more than 3 children, please enter the details below.

Your Funeral Choices

Burial

Cremation

Please provide details such as prepaid information or preferred cemetery.

Service Choice

Church Service

Crawford's Chapel Service

Crematorium Chapel Service

Service by the Graveside

No Service

Civil Celebrant

Clergy

Other Information

A Few Of Your Favourite Things

A place to record those personal touches for your service.

Music

Flowers

Sporting Teams/ Personal Interests

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Your Service, Your Choices

Your Personal Details

Your Parent's Details

Your Relationship Details

Your Children's Details

Child 1

Child 2

Child 3

Your Funeral Choices

A Few Of Your Favourite Things

A place to record those personal touches for your service.