CeremoniesOnline.co.nz
Funeral Form
The funeral service will be written based on the personal information you supply us.
Each funeral service is written as a celebration of a persons life. The cost - $200.

We guarantee your service will be emailed to you within 24 hours of payment verification.
Please fill in the Important Personal Information below and click 'Submit' to proceed..
If you have any privacy concerns, please read our Privacy Policy
All Questions are Optional

Once this form is submitted we make personal contact with you via email.


Please supply this Important Information:

Name of the deceased:


Date of Birth:


Date of Death:



Now to the Important Information:

What do you have in mind for the ceremony? Eg. Simple, spiritual, religious..

Where are you holding the ceremony? eg. church, funeral home, family home..


In your view how many people will be attending the funeral?

Will there be speakers at the Funeral?


If Yes .. .. Name the persons and what they will be speaking on? e.g. childhood, employment colleague, family life.

Family Member information: eg. spouse, children, grandchildren..

Summary of the person's history. eg. Where they were born, where they lived..

Employment information and achievements..


Recreational Interests and Travel:


Their Nature eg hardworking, kind, quiet, loved people, private?


Their Good and Bad traits


In your view what would they like to be remembered by?


Payment and Contact Details:
When payment is verified we write a draft ceremony, then closely work with you to make it perfect.
Your satisfaction is guaranteed.


Name:


Phone Number:


Fax Number:


Email Address:




Your Postal Address:



Residential Address:


The Cost is NZ $200.
How will you be Paying?



If Paying by Credit Card:
We will contact you directly by phone for your card details or fax them to:
(09) 360 7179

If Paying by Bank Transfer:

(use our currency converter)
Transfer $200.00 to

ASB Bank
12 3039 0872168 003

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CeremoniesOnline LTD
Phone:
(09) 360 7176
027 657 3810


FAX:
(09) 360 7179

Postal Address:
Apt 1F,
10 Crummer Road,
Grey Lynn 1021


Once this form is 'submited' and payment is received, we will contact you via Email or Phone to confirm payment.
Thank You.