Our Services

Recording Your Choices

Personal Profile

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

My Personal Details
Surname (Mr/Mrs/Ms/Miss/Dr etc)
 
Name at birth
 
First names
 
Address
 
Birth date
 
Birth place
 
Ethnicity
 
Are you descended from NZ Maori?(Yes/No/Don't know)
 
If not born in NZ, year of arrival in NZ
 
Profession/Occupation
 
Full name of father
 
Profession/Occupation of father
 
Full maiden name of mother
 
Profession/Occupation of mother
 

Marriage/Civil Union Details
Married/civil union/separated/divorced
 
First marriage/union details
 
Where married/united
 
Living spouse/partner's birth date
 
Second and subsequent marriages/unions
 
Divorce/separation details
 

Family Details
Children living
 
Sons' birth dates
 
Daughters' birth dates
 
Are you a justice of the Peace
 
Are you a Marriage Celebrant
 

Service Record
Service No.
 
Overseas/NZ service
 
Which war/Rank
 
Unit or regiment
 

My Funeral Details
Name and address of next of kin/executor who would be expected to make the funeral arrangements.
 
Name and address of solicitor or other person holding the will
 
Name of the funeral director to arrange the funeral
 
Is the funeral Pre arranged/Pre paid?
 
Name and address of preferred priest/clergy/celebrant
 
Venue of service
 
Casket choice (if known)
 
Burial or cremation
 
Plot (if any) New/Re-open
 
Ashes placement: Scatter/Inter
 
Flowers preferred
 
Donations at service to
 
Name of employer
 
Name of doctor
 
Who would you like to be asked to speak/do a reading at your funeral
 
Who would you like to be pallbearers
 
Music preferences for the service
 
Hymn or song choices for the service
 
Special readings for the service (e.g. from the Bible, verse, books)
 
Any special instructions
 
List the names and addresses of next of kin to be informed
 
List the names and addresses of friends, relatives, clubs, organisations etc you would like contacted regarding the funeral service
 
Click here to submit the form to Sibuns Funeral Directors and Advisors for us to keep on record