My Funeral Planner Form Page 2
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15MY PERSONAL INFORMATION
MY PERSONAL INFORMATION
MY PERSONAL INFORMATION
First Names
Surname
Male
Female
Date of Birth:
/
/
Place of Birth
If born overseas year of arrival in Australia
Usual Residence
Contact numbers
Email
M y Fu n e r a l
Occupation during working life
Retired:
Yes
No
Veteran: Yes
No
P l a n n e r
Aboriginal or Torres Strait Islander: Yes
No
Father’s full name
Occupation
Mother’s name & maiden name
Occupation
Marital status: Never Married
Married
Divorced
Widow/Widower
De Facto
Unknown
First Marriage
Town/Country
Age:
To Whom:
Second Marriage
Town/Country
Age:
To Whom
First Names of Children and date of Birth
Details of Next of Kin or Contact Person in charge of funeral arrangements
Name
Address
Relationship
Contact Numbers
Email
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Parent category: Life