Filling out the form online prior to meeting with our pre-plan specialist is a safe and convenient way to document your information and your wishes. All information is kept confidential and is never shared. Voyage Funeral Home has a very strict privacy policy. We respect your personal security and privacy. NOTE: Certain questions are asked as they are required by the government in order to issue a death certificate upon ones passing.Appointment location preference220 Hespeler Avenue (Hespeler & Henderson Hwy) MAIN OFFICE1577 Pembina Hwy (By appointment only)472 Kirkfield AveHome visitLegal name First Middle Last Maiden Name MaleFemaleSocial Insurance #Residence Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code PhoneCell phonePlace Of BirthDate Of Birth Date Format: MM slash DD slash YYYY AgeLegal Marital Status (Please Select One)Never MarriedMarriedWidowedDivorcedSeparatedCommon Law By MarriedFull Name Of Spouse First Middle Last Maiden Name OccupationIndustry Or BusinessFull Name Of Father First Last Place Of BirthFull & Maiden Name Of Mother First Middle Last Maiden Name Place Of BirthDoes The Deceased Have A Will?YesNoEXECUTOR/EXECUTRIXName First Middle Last Relationship To DeceasedMailing Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Primary PhoneCell PhoneINFORMANT (IF DIFFERENT THAN EXECUTOR OR IF EXECUTOR DOESN’T EXIST)Name First Middle Last Relationship To DeceasedLocation Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Primary PhoneCell PhoneEmail Other ContactsMy Wishes – What kinds of final arrangements would you like to have?From Simple Cremation to a Traditional Earth Burial, there are several options when it comes to your final wishes. Everyone is unique and what may appeal to one may not appeal to another. At Voyage we respect your wishes and will never suggest products and/or services you don’t want nor need.Traditional Earth Burial ServiceYesNoNotes:Funeral Service With Cremation To FollowYesNoNotes:Cremation With Memorial ServiceYesNoNotes:Simple CremationYesNoNotesUrnI have my ownI am interested in looking at your urn selectionYes – I'd like more information on additional pre-plan productsAssurant Travel ProtectionFinal Documents ServiceIf a death should occur while out of the country or just out of town on a brief trip, bringing a loved one back home can be a very complicated and expensive process. We offer Assurant Travel Protection – which takes care of all of the details and expenses. Another product available is Assurant’s Final Document Services (FDS). A pioneer in estate documentation administration, details of the FDS option is available through Voyage’s pre-plan specialist.*BY CLICKING THE SUBMIT BUTTON BELOW ON THIS PAGE, YOU BELIEVE THE INFORMATION RECORDED ABOVE TO BE ACCURATE & TRUE.CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
