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MY FI NAL WISHES

B E C A U S E W E C A R E

A PERSONAL RECORD OF MY CELEBRATION OF LIFE

Newcastle Affordable Funerals is dedicated to excellence in the provision of funeral direction and as a more affordable option. Newcastle Affordable Funerals is a locally owned (family) and operated funeral company with experienced staff who will provide the very best funeral service with a genuine personal touch and we allow you the time to decide on what is the most appropriate service for your situation.

Our funeral arranging staff have many years of experience in the funeral industry within Newcastle & The Hunter area and will provide the best advice that we can offer to ensure that you have a fitting service for your loved one. With so many of the well-known funeral companies in our area now being run by one organisation based in Sydney, some feel that the personal attention to detail can be lost so we felt it was time that an alternative and more affordable option was available for you.

THE BENEFITSPRE-PLAN YOUR FUNERAL AND HAVE IT YOUR WAYIt’s a good opportunity to have an open family discussion about your preferences. This way everyone is aware of your wishes and knows who to contact and where important documents are kept.

By pre-planning your funeral, you can choose the type and style of funeral service you would like and how much you wish to spend.

A few decisions now will save your family a lot of anguish later.

You are able to select from below:

If you require any help please contact one of our friendly staff at Newcastle Affordable Funerals on 0428 910 135 and we will work through it together with you.

• The type and style of funeral

• A burial or cremation

• Which cemetery or crematorium

• The type and style of coffin, casket or flowers

• The type of death notices

• Special features in the service, suchas a poem or piece of music

• The wishes of your family and friends

• How much you would like to spend

PERSONAL & FAMILY DETAILS

Title Mr Mrs Ms Miss Other _________________

Surname ________________________________________________________________

First names ______________________________________________________________

Gender Male Female

Address _________________________________________________________________

Suburb_________________________________ State ________ Postcode _________

Home phone ____________________________________________________________

Work phone _____________________________________________________________

Mobile phone ____________________________________________________________

Date of birth _____________________________________________________________

Place of birth ____________________________________________________________

______________________________________________________State _____________

Country _________________________________________________________________

If born overseas, the year of your arrival in Australia __________________________

Main occupation during working life ________________________________________

Are you of Aboriginal origin Yes No

Are you of Torres Strait Islander origin Yes No

Newcastle Affordable Funerals | 4

MY MARRIAGE DETAILS

Current Marital Status Widow/er Married Divorced De facto

Never Married

Place of Marriage (1st) ____________________________________________________

_________________________________________ Date of marriage _______________

Country __________________________________ Age at date of marriage _________

Full name of spouse (at time of marriage) ____________________________________

_________________________________________________________________________

Place of Marriage (2nd) ___________________________________________________

_________________________________________ Date of marriage _______________



_________________________________________________________________________

Place of Marriage (3rd) ____________________________________________________

_________________________________________ Date of marriage _______________



_________________________________________________________________________


PENSION TYPE

Aged Veterans Carer Invalid Other _______________________

Pension Number _________________________________________________________

MY PARENTS

My Father’s First Given Name/s ____________________________________________

My Father’s Surname _____________________________________________________

My Mother’s First Given Name/s ___________________________________________

My Mother’s Maiden Name ________________________________________________

MY CHILDREN (please state if deceased)

Given Names Date of Birth Gender Deceased

1 _______________________________________ _____________ M F

2 _______________________________________ _____________ M F

3 _______________________________________ _____________ M F

4 _______________________________________ _____________ M F

5 _______________________________________ _____________ M F


MY SERVICE

I prefer my service to be conducted by

Newcastle Affordable Funerals Dailey Family Funerals

I wish for my service to be held in

Reflections Chapel Glendale

Church (name of Church) _______________________________________________

Other Venue __________________________________________________________

My wish is to be cremated at

Newcastle Memorial Park Lake Macquarie Memorial Park

Another Crematorium ___________________________________________________

Pre-Paid Property (Plot) _________________________________________________

Please hold my cremated remains for family members to collect Yes No

Please place my cremated remains at _______________________________________

Please scatter my cremated remains at _____________________________________

If burial crypt or vault – I wish to be interred in _______________________________

________________________________________________________________ Cemetery

Grave details (if known) ___________________________________________________

I hold the Right of Burial Yes No

If no, please provide name of:

Right of Burial holder _____________________________________________________

PENSION TYPE

Aged Veterans Carer Invalid Other _______________________

Pension Number _________________________________________________________

MY PARENTS

My Father’s First Given Name/s ____________________________________________

My Father’s Surname _____________________________________________________

My Mother’s First Given Name/s ___________________________________________

My Mother’s Maiden Name ________________________________________________

MY CHILDREN (please state if deceased)

Given Names Date of Birth Gender Deceased

1 _______________________________________ _____________ M F

2 _______________________________________ _____________ M F

3 _______________________________________ _____________ M F

4 _______________________________________ _____________ M F

5 _______________________________________ _____________ M F


My wishes are for the following to conduct my service. (Clergy/Celebrant/Friend)

_________________________________________________________________________

_________________________________________________________________________

NEWSPAPER NOTICES

My wish is for a funeral notice Yes No

Newcastle Herald Sydney (The Daily Telegraph) Dailey’s Website

Facebook Other ___________________________________________________

My notice should be placed Before service After service

I request flowers Yes No

FLORAL TRIBUTE FOR MY CASKET

My wish is for my flowers to be in (colour) ___________________________________

I request that my flowers include (variety) ____________________________________

_________________________________________________________________________

In lieu of flowers please make donation to ___________________________________

_________________________________________________________________________


MUSIC PREFERENCE

My wish is for

Recorded music Vocalist Organist Piper Choir

Other _________________________________________________________________

_________________________________________________________________________

My wish is for the following songs to be played/performed at my service

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Other special requests that I would like for my service

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________


REQUESTS FOR MY SERVICE

Yes No Family to decide

Viewing (before my service)

Memorial book (signature register)

Order of service funeral A5 booklet

Catering – Reflections Function Centre

Catering – other ____________________________

Photo on coffin

Balloon on coffin

Balloon release (max 19 allowed by law)

DVD presentation

Video recording of service complimentary

on availability

PLANNING MY FUNERAL SERVICE

My wish is for this information to be used to prepare my eulogy.

My special memories are

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Some of my most important accomplishments

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________


My special interests are

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My hobbies

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My proudest moments are

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Please acknowledge the following people or organisations at my service (family, carers, hospitals)

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Attributes about my character that I would like to be remembered for (morals, values, passions)

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________


Something I would like to be remembered for

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My sporting achievements

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Symbols I would like displayed at my service (eg photos, medals, favourite footy jumper etc)

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My working life

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Clubs and community groups I was involved in

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________


The most important people in my life are

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My wish is for the following to be read at my service (poem/letter)

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My most memorable time was

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Memories of my childhood

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

My growing up years

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________


PERSON MAKING MY ARRANGEMENTS

Name ___________________________________________________________________

Relationship to you _______________________________________________________

Address _________________________________________________________________

Suburb ___________________________________________________ State _________

Phone number ___________________________________________________________

Mobile __________________________________________________________________

MY NEXT OF KIN

Name ___________________________________________________________________


Address _________________________________________________________________

Suburb ___________________________________________________ State _________

Phone number ___________________________________________________________

MY EXECUTOR

Name ___________________________________________________________________


Address _________________________________________________________________

Suburb ___________________________________________________ State _________

Phone number ___________________________________________________________


MY SOLICITOR

Name ___________________________________________________________________

Firm _____________________________________________________________________

Address _________________________________________________________________

Suburb ___________________________________________________ State _________

Location of my will ________________________________________________________

I have a Pre-Paid Funeral Plan with _______________________________________

Funeral Fund Name ______________________________________________________

Contract Number ________________________________________________________

I have a Funeral Insurance Policy with ____________________________________

I give permission for members of my family to make changes as they wish.

OR

I would prefer these arrangements to remain as my wishes.

Signature _________________________________ Date _________________________

PO Box 122 Lambton 2299

For further details, or if you would like to proceed with a Pre-Arranged, Pre-Paid, Fixed Priced Funeral Plan or pay off a funeral bond with Newcastle Affordable Funerals, please call us 0428 910 135 or email your enquiry to [email protected]


A Newcastle family owned and operated company. Please call us on 0428 910 135 for 24 hour caring service.

B E C A U S E W E C A R E

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