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office@gatewayfuneral.co.nz+647 308 6102

ARRANGEMENTS

We need your details of your loved one to get started on the arrangement. You can fill in the form below or one of our staff can assist you in getting the right information required.

Surname

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Maiden Name

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First Names

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Residence

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Email

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Date of Birth

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Date of Death

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Age

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Place of Birth

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Yrs in NZ

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Occupation

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Place of Death (full address)

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Ethnicity

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Mother's full name

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Mother's name at birth

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Mother's Occupation

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Father (or parent 2) full name

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Father (or parent 2) name at birth

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Father (or parent 2) Occupation

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Relationship status

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Most recent relationship: First name(s) of partner

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Surname of partner

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Place of marriage

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Age of deceased at marriage

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Age of partner Age /Deceased

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Second most recent: First name(s) of partner

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Surname of partner

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Place of marriage

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Age of deceased at marriage

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Age of partner Age /Deceased

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Third most recent: First name(s) of partner

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Surname of partner

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Place of marriage

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Age of deceased at marriage

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Age of partner Age /Deceased

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Age of daughters living

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Age of sons living

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Service at

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Date

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Time

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Cremation / Burial at

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Do you require vehicle assistance

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Gravemarker Stake / Cross (plain or carved)

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Do you require catering assistance?

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Service Sheets

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Choose A4 / A5 and Insert Quantity

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Slideshow?

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Live Stream?

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Memory Book?

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Would you like assistance with ordering flowers?

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Address

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Gateway Funeral Services
Whakatane - 17 Awatapu Drive, Whakatane
Kawerau - 4 Ranfurly Court, Kawerau (open by appointment)

Phone us on (07) 3086102

Or you can email the team office@gatewayfuneral.co.nz

Call us