27 Main St. County Road 8
P.O. Box 142
Elgin, ON K0G 1E0
Phone: 613 359-5555
Fax: 613 359-6329

Order Flowers

Offer a gift of comfort and beauty to a family suffering from loss.

Immediate Need

If you have immediate need of our services, we're available for you 24 hours a day.

Obituaries & Tributes

It is not always possible to pay respects in person, so we hope that this small token will help.

Pre-Arrangement

A gift to your family, sparing them hard decisions at an emotional time.

Online Funeral Planning


I. Biographical Information
Full Name:
Date of Death:
Address 1:
Address 2:
City Name:
Province:
Postal Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
Province of Birth:
Highest Education Level:
Please select Grade/Years of Education completed:
   
Social Security Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded In Death
Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:

II. Military Record
Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (month/day/year)
Date of Discharge: (month/day/year)
Rank at Discharge:
Location of a Copy of Discharge (DD214):
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences
Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

Miscellaneous Notes and Instructions:

Please select one of the options below:

Please send me information

Please contact me to schedule an appointment

Please place my information on file


 

 

 

 

365 Days of Healing

Grieving doesn't always end with the funeral: subscribe to our free daily grief support email program, designed to help you a little bit every day, by filling out the form below.

52 Weeks of Support

It's hard to know what to say when someone experiences loss. Our free weekly newsletter provides insights, quotes and messages on how to help during the first year.

Menu