• Please enter details of the person for whom the funeral is being arranged.
• A meeting with a funeral director is still required to complete the arrangement process. If you encounter any difficulties when completing the form, the funeral director will assist you at the time you meet with them.
• If you do not wish to provide certain details online, they can be recorded by the funeral director at the time of your meeting with them.
• There is no obligation to pay for your funeral at this time, and changes can be made to your funeral arrangements whenever necessary.
• The arrangement details are kept securely at Kings Australia until they are required.
• We do require a phone number or email address to be able to contact you.

Please enter details of the person for whom the funeral is being arranged.

First Name
Last Name
Residential Address
Suburb/City
State	Please select New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Country
Postcode
Email
Phone
Fax
Gender	Male Female
Date of Birth	01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1910 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Country of Birth
Period of residence in Australia	From All my life 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Main occupation
Pension details	Not applicable Age Carers Disability Newstart Veterans' Affairs

Marital Status	Divorced Married Never married Separated Widow Widower
Previously married?	Yes No
If yes, we will need these marriage details when we meet.
Place of marriage
Age when married
Spouse's name
Children's names (in birth order)
We require the birth dates of each child however we can collect this information when we meet.

Father's Name
His Occupation
Mother's Name
Her Maiden Name
Her Occupation

Church
Our Chapel
Crematorium Chapel	Geelong Memorial Park Ballaarat Crematorium Fawkner Crematorium Memorial Park, Altona The Necropolis, Springvale
Other

Clergy	Anglican Baptist Buddhist Catholic Church of Christ Greek Orthodox Hare Krishna Islamic Jehovah's Witness Lutheran Presbyterian Revivalist Russian Orthodox Serbian Orthodox Seventh Day Adventist Uniting Other
Celebrant	Male Female

Coffin		Solid Timber Particleboard
Casket		Solid Timber Protective Metal
Burial
	Location	Bellbrae Cemetery Fawkner Memorial Park Geelong Memorial Park Memorial Park, Altona Queenscliff Public Cemetery The Eastern Cemetery, Geelong The Necropolis, Springvale Werribee General Public Cemetery
	Grave Type	Lawn Grave Lawn Monument Grave Monument Area Concrete Lined Grave Other
Cremation
	Location	Geelong Memorial Park Ballaarat Crematorium Fawkner Crematorium Memorial Park, Altona The Necropolis, Springvale
	Ashes placement	Ashes scattering (sea) Ashes scattering (air) Ashes scattering (land) Existing Grave Memorial Garden Temporary Memorial Garden Urn

Geelong Advertiser Herald Sun The Age/other	You can type your own death notice here.
Music	Musician (e.g. organist, singer) CD/Tape
Flowers	Sheaf or wreath Half sheaf or wreath Posy Single rose
Donations	Donations and flowers, or Donations in leiu of flowers Donations made to: Asthma Foundation Barwon Health Brotherhood of St Laurence Diabetes Australia Grace McKellar Centre Leukaemia Foundation Lifeline MS Society National Heart Foundation Osteoporosis Victoria Peter McCallum Cancer Institute Salvation Army St Vincent de Paul Other
Order of service booklets	Quantity
Prayer cards	Quantity
Catering	Quantity
Vehicles	Mourning Car/s Limousine/s
Coffin Bearers	Family or friends Funeral staff
Audio Visual	Audio tape the service Video tape the service Multimedia photo presentation Basic photographs taken
If you have completed this form on the behalf of someone else, please provide your contact details.
First Name
Last Name
Address
Suburb/City
State	Please select New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Country
Postcode
Email
Phone
Fax