Life and Memorial Celebrations
Pre-Need Funeral Planning Questionnaire

* Compulsory fields

    1. Please give your full name, e-mail address and contact number.

    Full Name*

    Email Address*

    Contact Numbers (Landline & Mobile)*

    2. Does your enquiry regarding pre-planning a funeral relate to yourself or a loved one?*

    YourselfA loved one

    3. What is the approximate age of the person concerned?*

    20 or younger21-3031-4041-5051-6061-7071-8080 or older

    4. What is the family situation of the person concerned?*

    5. Do you or your loved one favour burial or cremation?*


    6. What are the religious or spiritual beliefs of the person concerned, if any?*