Pre-Arrange Online

Pre- Arranging On Line is a convenient alternative for someone who is out of town, or, does not wish to come into the funeral home. All your information will remain private.The information given to us will be transferred to a file folder, and kept with our other funeral home pre-arrangements. A letter will be sent to you to confirm we recieved the pre-arrangement.This online  pre-rangement would not be pre-paid, unless you choose to contact us. We will gladly go over all your pre-payment options if you wish.  Please, use the headings below as a guidline. That information will be used to send notice of the death to the federal and provincial governments, and to compose an at-need death notice. We will be in contact with you as soon as we recieve your information to provide you with all the costing involved and your payment options. Remember that there is no obligation to pre pay your services, however it will save your family the burden of takeing care of this at that time, not to mention there can be cost savings in pre paying now. Please ask us how.

**This page can be printed**

Name:

Address:

Birthplace:

Birthdate:

Mother:

Father:

Wife / Husband:

Daughter(s):

Son(s):

Sister(s):

Brother(s):

Grandchildren:

Greatgrandchildren:

Nieces  /Nephews:

Other:

Place Of Employment:

Profession:

Member Of What Organizations:

Place Of Funeral (ex: Chapel or Church):

Visitation(ex: 2-4 and 7-9):

Casket ( open / closed):

Organist:(yes /no.......favourate hymns)

Memorial Donations:

Name Of Cemetery:

Burial / Cremation:

Clergy:

Newspaper(s) For Death Notice(s):

Reception: (yes /no)

Name Of Executor(s):

Address Of Executor(s)

Phone Number(s) of Executors:

Relationship of Executor(s):

Death Notice: (You can compose it and send it to us through the links below) It will be kept on file.

**Please, send the above information to us by clicking on the following email address:

 johnrbush johnbushfuneral@bellnet,ca

or, print this page , fill it in, and mail the information to us at:

John R. Bush Funeral Home
80 Highland Avenue
Belleville Ontario. K8P-3R4

or, fax us at 1-613-968-7107

Call: toll free at 1-800-568-9714

Local: 1-613-968-5588

**Thank you for taking the time to fill out your pre-arrangement. A Funeral Director will be available to answer any of your questions.**