Pre-Arrangement Form - Your Information | Windsor Chapel Funeral & ...

Pre-Arrangement Form

Your Information

Step 1 of 1

Full Name*:

Address

Address*:

City*:

Country*:

State/Province*:

Zip/Postal code*:

Email Address*:

Phone Number:

Date of Birth:

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City of Birth:

Birth Province:

Spouse's Information

Spouse's Name:

Spouse's Maiden Name:

Spouse's Address

Address:

City:

Country:

State/Province:

Zip/Postal code:

Father & Mother Information

Work & Education

Education:

Your Occupation:

Kind of Business:

Company Name::

Military Information

Branch of Service:

Serial Number:

Date Enlisted:

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Rank at Discharge:

Date Discharged:

Su	Mo	Tu	We	Th	Fr	Sa
26	27	28	29	30	31	1	2	3	4	5	6	7
2	3	4	5	6	7	8	9	10	11	12	13	14
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23	24	25	26	27	28	29	30	1	2	3
30				4	5	6	7	8	9	10

Discharge on File at:

Copy of Discharge Papers:

Yes

Funeral Service Information

Place of Service:

I Prefer the Funeral Service to be:

Public

Private

Viewing for Family:

Yes

Viewing for Friends:

Yes

Religious Denomination:

Place of Worship:

Lodge or Union:

Disposition Information

I Prefer:

Cemetery:

Address:

Phone:

I Have Made A Last Will & Testament:

Yes

Additional Information

Flower Preference:

Music Selections:

Casket Pallbearers:

Jewelery:

Glasses:

Clothing:

Special Instructions

Send Information

Our Locations

Central Chapel
1700 Tecumseh Rd. East
Windsor, ON N8W 1C7
Phone: (519) 253-7234

Get Directions

Central Chapel | (519) 253-7234
1700 Tecumseh Rd. East, Windsor, Ontario N8W 1C7

Banwell Chapel | (519) 253-7235
11677 Tecumseh Rd. East, Windsor, Ontario N8N 1L8

South Chapel | (519) 253-7236
3048 Dougall Avenue, Windsor, Ontario N9E 1S4

Proudly Canadian | Owned & Operated by Arbor Memorial Inc.

Admin Login | Website powered by FuneralTech & TA | Privacy Policy | Terms of Use

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