Recording Your Choices

These need to be recorded and kept on file. Our personalised planning form can be completed on-line and submitted to your nearest location or printed so you can add it to your funeral pack.

It may be a good idea to also keep a copy with your will and let your family and close friends know about it.

Beth Shan Funerals are happy to arrange a personal visit to talk about your requirements.
Call us on 06 835 9925 and we can discuss the options with you.

Download Form

The following includes the information Required by Registrar – General of Births, Deaths & Marriages. Please complete fully to ensure your personal details are accurately recorded and your wishes followed.

1My Personal Details:

2My Marriage/ Civil Union Details:

3My Family Details:

4My Funeral Details:

MY PERSONAL DETAILS:
Choose One:
- Mr
- Mrs
- Ms
- Miss
- Dr
Surname:*
First Names:*
Name at birth:
Address:*
Email:*
Phone:*
Mobile:
Date of birth:*
DD slash MM slash YYYY
Place of birth:*
Are you descended from NZ Maori?:*
- Yes
- No
- Don't Know
Ethnicity:
If not born in NZ, what was your date of arrival in NZ:
Profession/ Occupation:
Full name of father:
Occupation of father:
Full maiden name of mother:
Occupation of mother
Do you hold an award/ honours (not military):*
- Yes
- No
Title:

MY MARRIAGE/ CIVIL UNION DETAILS:
Your situation:*
- Married
- Civil union
- Divorced
- De Facto
- Widowed
- Separated
- Never married
Most current marriage/ union details:
Your age at the time:
Full name of spouse/ partner at birth:
Place of marriage/ union:
Spouse/ partner's birth date:
Previous relationship details:
Your age at the time:
Full name of spouse/ partner at birth:
Place of marriage/ union:
If living, spouse/ partner's birth date:

MY FAMILY DETAILS:
If living, son/s birth date/s:
If living, daughter/s birth date/s:
Are you a Justice of the Peace:*
- Yes
- No
Are you a Marriage Celebrant:*
- Yes
- No
MY SERVICE RECORD:
Service number:
Overseas/ New Zealand service details:
Which war:
Rank:
Unit/ Regiment:

MY FUNERAL SERVICE:
Name of kin/ executor making the arrangements:*
Address:
Phone:
Mobile:
Name of Solicitor/ person holding will:
Address:
Phone:
Mobile:
Name of Employer:
Name of Doctor:
Name of Funeral Director:
Simplicity Plan
- Basic Plan
- Value Plan
- Complete Plan
- Premium Plan
- Custom
Is the funeral pre-arranged:*
- Yes
- No
Pre-paid:*
- Yes
- No
Preferred Priest/ Clergy/ Celebrant:
Venue of service:
Casket choice (if known):
Choose One:*
- Burial
- Cremation
Plot:
- None
- New
- Single
- Double
- Re-open
Ashes Placement:
- Scatter
- Interment
Cemetery/ Crematorium:
Flowers preferred:
In lieu of flowers, donations to:
Who would you like to speak/ do a reading:
Special readings for the service (from the bible, verse, books):
Music preferences for the service:
Hymn or song choices for the service:
Who would you like to be pallbearers (optional):
Any special instructions:
List names & phone numbers of next of kin to be informed:
List names, addresses & phone numbers of friends, relatives, clubs, organisations etc you would like contacted: