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

Maiden Name

First Names

Residence

Email

Date of Birth

Date of Death

Age

Place of Birth

Yrs in NZ

Occupation

Place of Death (full address)

Ethnicity

Mother's full name

Mother's name at birth

Mother's Occupation

Father (or parent 2) full name

Father (or parent 2) name at birth

Father (or parent 2) Occupation

Relationship status

Most recent relationship: First name(s) of partner

Surname of partner

Place of marriage

Age of deceased at marriage

Age of partner Age /Deceased

Second most recent: First name(s) of partner

Surname of partner

Place of marriage

Age of deceased at marriage

Age of partner Age /Deceased

Third most recent: First name(s) of partner

Surname of partner

Place of marriage

Age of deceased at marriage

Age of partner Age /Deceased

Age of daughters living

Age of sons living

Service at

Date

Time

Cremation / Burial at

Do you require vehicle assistance

Gravemarker Stake / Cross (plain or carved)

Do you require catering assistance?

Service Sheets

Choose A4 / A5 and Insert Quantity

Slideshow?

Live Stream?

Memory Book?

Would you like assistance with ordering flowers?

Address

Message Sent.

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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