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MY FI NAL WISHES
B E C A U S E W E C A R E
A PERSONAL RECORD OF MY CELEBRATION OF LIFE
Newcastle Affordable Funerals is dedicated to excellence in the provision of funeral direction and as a more affordable option. Newcastle Affordable Funerals is a locally owned (family) and operated funeral company with experienced staff who will provide the very best funeral service with a genuine personal touch and we allow you the time to decide on what is the most appropriate service for your situation.
Our funeral arranging staff have many years of experience in the funeral industry within Newcastle & The Hunter area and will provide the best advice that we can offer to ensure that you have a fitting service for your loved one. With so many of the well-known funeral companies in our area now being run by one organisation based in Sydney, some feel that the personal attention to detail can be lost so we felt it was time that an alternative and more affordable option was available for you.
THE BENEFITSPRE-PLAN YOUR FUNERAL AND HAVE IT YOUR WAYIt’s a good opportunity to have an open family discussion about your preferences. This way everyone is aware of your wishes and knows who to contact and where important documents are kept.
By pre-planning your funeral, you can choose the type and style of funeral service you would like and how much you wish to spend.
A few decisions now will save your family a lot of anguish later.
You are able to select from below:
If you require any help please contact one of our friendly staff at Newcastle Affordable Funerals on 0428 910 135 and we will work through it together with you.
• The type and style of funeral
• A burial or cremation
• Which cemetery or crematorium
• The type and style of coffin, casket or flowers
• The type of death notices
• Special features in the service, suchas a poem or piece of music
• The wishes of your family and friends
• How much you would like to spend
PERSONAL & FAMILY DETAILS
Title Mr Mrs Ms Miss Other _________________
Surname ________________________________________________________________
First names ______________________________________________________________
Gender Male Female
Address _________________________________________________________________
Suburb_________________________________ State ________ Postcode _________
Home phone ____________________________________________________________
Work phone _____________________________________________________________
Mobile phone ____________________________________________________________
Date of birth _____________________________________________________________
Place of birth ____________________________________________________________
______________________________________________________State _____________
Country _________________________________________________________________
If born overseas, the year of your arrival in Australia __________________________
Main occupation during working life ________________________________________
Are you of Aboriginal origin Yes No
Are you of Torres Strait Islander origin Yes No
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MY MARRIAGE DETAILS
Current Marital Status Widow/er Married Divorced De facto
Never Married
Place of Marriage (1st) ____________________________________________________
_________________________________________ Date of marriage _______________
Country __________________________________ Age at date of marriage _________
Full name of spouse (at time of marriage) ____________________________________
_________________________________________________________________________
Place of Marriage (2nd) ___________________________________________________
_________________________________________ Date of marriage _______________
Country __________________________________ Age at date of marriage _________
Full name of spouse (at time of marriage) ____________________________________
_________________________________________________________________________
Place of Marriage (3rd) ____________________________________________________
_________________________________________ Date of marriage _______________
Country __________________________________ Age at date of marriage _________
Full name of spouse (at time of marriage) ____________________________________
_________________________________________________________________________
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PENSION TYPE
Aged Veterans Carer Invalid Other _______________________
Pension Number _________________________________________________________
MY PARENTS
My Father’s First Given Name/s ____________________________________________
My Father’s Surname _____________________________________________________
My Mother’s First Given Name/s ___________________________________________
My Mother’s Maiden Name ________________________________________________
MY CHILDREN (please state if deceased)
Given Names Date of Birth Gender Deceased
1 _______________________________________ _____________ M F
2 _______________________________________ _____________ M F
3 _______________________________________ _____________ M F
4 _______________________________________ _____________ M F
5 _______________________________________ _____________ M F
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MY SERVICE
I prefer my service to be conducted by
Newcastle Affordable Funerals Dailey Family Funerals
I wish for my service to be held in
Reflections Chapel Glendale
Church (name of Church) _______________________________________________
Other Venue __________________________________________________________
My wish is to be cremated at
Newcastle Memorial Park Lake Macquarie Memorial Park
Another Crematorium ___________________________________________________
Pre-Paid Property (Plot) _________________________________________________
Please hold my cremated remains for family members to collect Yes No
Please place my cremated remains at _______________________________________
Please scatter my cremated remains at _____________________________________
If burial crypt or vault – I wish to be interred in _______________________________
________________________________________________________________ Cemetery
Grave details (if known) ___________________________________________________
I hold the Right of Burial Yes No
If no, please provide name of:
Right of Burial holder _____________________________________________________
PENSION TYPE
Aged Veterans Carer Invalid Other _______________________
Pension Number _________________________________________________________
MY PARENTS
My Father’s First Given Name/s ____________________________________________
My Father’s Surname _____________________________________________________
My Mother’s First Given Name/s ___________________________________________
My Mother’s Maiden Name ________________________________________________
MY CHILDREN (please state if deceased)
Given Names Date of Birth Gender Deceased
1 _______________________________________ _____________ M F
2 _______________________________________ _____________ M F
3 _______________________________________ _____________ M F
4 _______________________________________ _____________ M F
5 _______________________________________ _____________ M F
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My wishes are for the following to conduct my service. (Clergy/Celebrant/Friend)
_________________________________________________________________________
_________________________________________________________________________
NEWSPAPER NOTICES
My wish is for a funeral notice Yes No
Newcastle Herald Sydney (The Daily Telegraph) Dailey’s Website
Facebook Other ___________________________________________________
My notice should be placed Before service After service
I request flowers Yes No
FLORAL TRIBUTE FOR MY CASKET
My wish is for my flowers to be in (colour) ___________________________________
I request that my flowers include (variety) ____________________________________
_________________________________________________________________________
In lieu of flowers please make donation to ___________________________________
_________________________________________________________________________
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MUSIC PREFERENCE
My wish is for
Recorded music Vocalist Organist Piper Choir
Other _________________________________________________________________
_________________________________________________________________________
My wish is for the following songs to be played/performed at my service
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Other special requests that I would like for my service
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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REQUESTS FOR MY SERVICE
Yes No Family to decide
Viewing (before my service)
Memorial book (signature register)
Order of service funeral A5 booklet
Catering – Reflections Function Centre
Catering – other ____________________________
Photo on coffin
Balloon on coffin
Balloon release (max 19 allowed by law)
DVD presentation
Video recording of service complimentary
on availability
PLANNING MY FUNERAL SERVICE
My wish is for this information to be used to prepare my eulogy.
My special memories are
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Some of my most important accomplishments
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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My special interests are
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My hobbies
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My proudest moments are
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Please acknowledge the following people or organisations at my service (family, carers, hospitals)
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Attributes about my character that I would like to be remembered for (morals, values, passions)
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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Something I would like to be remembered for
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My sporting achievements
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Symbols I would like displayed at my service (eg photos, medals, favourite footy jumper etc)
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My working life
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Clubs and community groups I was involved in
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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The most important people in my life are
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My wish is for the following to be read at my service (poem/letter)
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My most memorable time was
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Memories of my childhood
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
My growing up years
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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PERSON MAKING MY ARRANGEMENTS
Name ___________________________________________________________________
Relationship to you _______________________________________________________
Address _________________________________________________________________
Suburb ___________________________________________________ State _________
Phone number ___________________________________________________________
Mobile __________________________________________________________________
MY NEXT OF KIN
Name ___________________________________________________________________
Relationship to you _______________________________________________________
Address _________________________________________________________________
Suburb ___________________________________________________ State _________
Phone number ___________________________________________________________
MY EXECUTOR
Name ___________________________________________________________________
Relationship to you _______________________________________________________
Address _________________________________________________________________
Suburb ___________________________________________________ State _________
Phone number ___________________________________________________________
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MY SOLICITOR
Name ___________________________________________________________________
Firm _____________________________________________________________________
Address _________________________________________________________________
Suburb ___________________________________________________ State _________
Location of my will ________________________________________________________
I have a Pre-Paid Funeral Plan with _______________________________________
Funeral Fund Name ______________________________________________________
Contract Number ________________________________________________________
I have a Funeral Insurance Policy with ____________________________________
I give permission for members of my family to make changes as they wish.
OR
I would prefer these arrangements to remain as my wishes.
Signature _________________________________ Date _________________________
PO Box 122 Lambton 2299
For further details, or if you would like to proceed with a Pre-Arranged, Pre-Paid, Fixed Priced Funeral Plan or pay off a funeral bond with Newcastle Affordable Funerals, please call us 0428 910 135 or email your enquiry to [email protected]
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A Newcastle family owned and operated company. Please call us on 0428 910 135 for 24 hour caring service.
B E C A U S E W E C A R E