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Contact Us
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Menu
Home
About
About Us
Our Staff
Galleries
Funeral Home Gallery
Crematorium Gallery
In Memory Of…
Services
Services
Simple Cremation
Cremation With Memorial Service
Funeral Service With Cremation to Follow
Traditional Earth Burial
Death of a Child
Anticipating a Death at Home
Urns
Scattering Service
Pre-Planning
Catering
Forms
Simple Cremation Form
Pre-Plan Arrangement Form
Ask the Funeral Director™
Articles
Ask the Funeral Director Show
CHVN Radio Ads
FAQ’s
Healing Broken Hearts
Obituaries
Voyage Obituaries
Free Press Passages
Will Kit
Resources
Financial Assistance
Grief Support and Healing
Documents & Info
Acts & Regulations
Deceased Estate Handbook
Manitoba Land Titles
CPP Death Benefit Info
Vital Stats Death Document
Veterans Last Post Fund
Victims of Crime
Make a Donation
Contact
Contact Us
Careers
Simple Cremation Form
ARRANGEMENTS
Deceased Legal Name
First
Middle
Last
Male
Female
Social Insurance #
Residence
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Place Of Birth
Date Of Birth
MM slash DD slash YYYY
Place Of Death
Date Of Death
MM slash DD slash YYYY
Legal Marital Status (Please Select One)
Never Married
Married
Widowed
Divorced
Separated
Common Law By Married
Full Name Of Spouse
First
Middle
Last
Maiden Name
Occupation
Industry Or Business
Full Name Of Father
First
Last
Place Of Birth
Full & Maiden Name Of Mother
First
Middle
Last
Maiden Name
Place Of Birth
Does The Deceased Have A Will?
Yes
No
EXECUTOR / EXECUTRIX
Name
First
Middle
Last
Relationship To Deceased
Mailing Address
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Primary Phone
Cell Phone
Do you have more than 1 Executor?
*
Yes
No
Name
First
Middle
Last
2nd Executor's Information
Relationship To Deceased
Mailing Address
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Primary Phone
Cell Phone
Do you have more than 2 Executors?
*
Yes
No
Name
First
Middle
Last
3rd Executor's Information
Relationship To Deceased
Mailing Address
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Primary Phone
Cell Phone
INFORMANT (IF DIFFERENT THAN EXECUTOR OR IF EXECUTOR DOES NOT EXIST)
Name
First
Middle
Last
Relationship To Deceased
Location
Street Address
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Primary Phone
Cell Phone
Email
Other Contacts
Simple Cremation
Yes
No
Notes:
CREMATION AUTHORIZATION
Pacemaker?
*
Yes
No
Personal belongings
*
Yes
No
List of belongings
Urn
I have my own
I am interested in looking at your urn selection
OBITUARY
Obituary
*
Yes
No
(The obituary will be posted on Voyage Funeral Homes website free of charge)
Picture
Yes
No
Date to be printed
MM slash DD slash YYYY
Post in Free Press?
Yes
No
Notes:
Please upload obituary + picture if you have one completed
Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 300 MB.
(Accepted file types include Word Doc, and common image files png, jpeg, jpg)
Consent
*
I agree to the following
As next of kin or legal representative of the deceased, I have the legal right and take FULL responsibility to authorize the cremation and disposition of the cremated remains. I understand if the deceased has a pacemaker it must be removed before cremation takes place. I further agree that the crematorium, funeral home, and funeral director, are free from any liability on the account of said authorization, cremation or disposition. The crematorium, funeral home, and funeral director are not responsible for jewelry or personal belongings left with the deceased at the time of death.
*IMPORTANT
*
Traditional Service followed by Cremation
Viewing prior to Cremation
No Viewing
Other
I, the undersigned, also certify that no identification or viewing will take place prior to authorization of cremation. Unless otherwise agreed upon.
*BY CLICKING THE SUBMIT BUTTON BELOW ON THIS PAGE, YOU BELIEVE THE INFORMATION RECORDED ABOVE TO BE ACCURATE & TRUE.
Signature Name
*
First
Last
Signature
*
Signature Consent
*
By signing above, and checking this box you agree to the following terms:
I confirm my identity, and the contents and accuracy of this cremation form, and authorize Voyage Funeral Homes to file and process it accordingly.
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.
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