Pre-Arrangement Form

Pre planning may or may not include the option of pre paying: If you would like to record your wishes you can do so on the form below and submit that to us for safe keeping. We are also happy to meet with you and your family to discuss ideas, options, answer questions and address any concerns you might have about funeral planning. Please make contact with us if you would like to meet.

Personal Details

Family Name

First Name(s)

Name at Birth (If different)

Date of Birth

Place of Birth

Street Address

City

Phone

Usual Occupation (Before retirement)

Ethnic Group

Maori Descent

Civil Honours (eg. J.P OBE etc)

Next of Kin Details

Full Name

Street Address

City

Family Information (Required by Registrar of Births, Deaths and Marriages)

Children Details

Son(s) Date(s) of Birth

Daughter(s) Date(s) of Birth

Parent Details

Fathers Name

Fathers Birth Name

Fathers Occupation

Mothers Name

Mothers Birth Name

Mothers Occupation

Your Marriage Details

Funeral Details

Service to be conducted by

Details of service and any special instructions

Other Important Details

Name of Family Doctor

Address of Family Doctor

Name of Solicitor

Address of Solicitor

Name of Executor(s)

Date of Last Will

Will Held By

Additional information you would like us to be aware of

The Wilson Funeral Homes

Main Office: 375 Adelaide Road, Newtown, Wellington
Phone: 04 389 6069
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142 Karori Road, Karori, Wellington
(Open by appointments only)
Phone: 04 476 5292
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Newtown - (04 389 6069)

Karori - (04 476 5292)